SynthesisJournal of orthopaedic surgery and research2017
Extramedullary versus intramedullary femoral alignment technique in total knee arthroplasty: a meta-analysis of randomized controlled trials.
Synthesis in Journal of orthopaedic surgery and research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed.
- Perioperative comparison between robotic-assisted and freehand total knee arthroplasty : A quasi-randomized controlled trial.Orthopadie (Heidelberg, Germany) · 2026Trial
- Ligament-tension-guided versus fixed-angle distal femoral coronal target selection in primary total knee arthroplasty using a manual alignment workflow: a retrospective cohort study.BMC musculoskeletal disorders · 2026Article
- Article
- Robotic total knee arthroplasty for moderate to high-grade valgus knee deformity: technique and outcomes.SICOT-J · 2025Article
- Comparison of the efficacy of robot-assisted total knee arthroplasty in patients with knee osteoarthritis with varying severity deformity.Journal of orthopaedic surgery and research · 2024Article
- Robotics in total knee replacement: Current use and future implications.World journal of orthopedics · 2024Article
- A New Concept of Using Femoral Condyles Surface for Femoral Component Alignment During Total Knee Arthroplasty: A Technical Note.Indian journal of orthopaedics · 2023Article
- Primary total knee arthroplasty in hemophilic arthropathy.EFORT open reviews · 2023Review
- Learning curve of robot-assisted total knee arthroplasty and its effects on implant position in asian patients: a prospective study.BMC musculoskeletal disorders · 2023Article
- Is the femoral intramedullary alignment already actual in total knee arthroplasty?Journal of experimental orthopaedics · 2023Review
- The Effect of Intramedullary vs Extramedullary Tibial Guides on the Alignment of Lower Extremity and Functional Outcomes Following Total Knee Arthroplasty: A Randomized Clinical Trial.The archives of bone and joint surgery · 2023Article
- Evaluation of Blood Loss in Conventional vs MAKOplasty Total Knee Arthroplasty.Arthroplasty today · 2022Article
- Observational
- Comparison of serum inflammatory indicators and radiographic results in MAKO robotic-assisted versus conventional total knee arthroplasty for knee osteoarthritis: a retrospective study of Chinese patients.BMC musculoskeletal disorders · 2022Article
- A simple technique to perform total knee replacement without violating the femoral canal: early clinical results on a cohort of 303 patients.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2020Article
- Knee arthroplasty with hardware removal: complication cascade. Is it preventable?BMJ case reports · 2020Article
- A novel extramedullary technique to guide femoral bone preparation in mobile unicompartmental knee arthroplasty based on tibial cut and overall alignment.Journal of orthopaedic surgery and research · 2020Article
- TKA with retained hardware guided by intraoperative ultrasonography - a case report.BMC surgery · 2019Article
- Blood management in fast-track orthopedic surgery: an evidence-based narrative review.Journal of orthopaedic surgery and research · 2019Review
- A novel surgical technique to perform total knee arthroplasty in patients with inaccessible femoral medullary canal.Journal of orthopaedicsArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is no consensus whether the use of the extramedullary femoral cutting guide takes advantage over the intramedullary one in total knee arthroplasty. The aim of this study was to compare the extramedullary femoral alignment guide system with the conventional intramedullary alignment guide system for lower limb alignment, blood loss, and operative time during total knee arthroplasty.
methodsThe Medline, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang Chinese Periodical, Google, and reference lists of all the included studies were searched for randomized controlled trials. The following parameters were compared between the extramedullary technique and the intramedullary technique: (1) lower limb coronal alignment, (2) coronal alignment of femoral component, (3) sagittal alignment of femoral component, (4) blood loss, (5) and operation time.
resultsFour randomized controlled trials consisting of 358 knees were included in our study. There was no significant difference between the extramedullary and intramedullary groups for the lower limb coronal alignment (RR = 1.20, 95%CI 0.28~5.21, n.s.), coronal alignment of femoral component (RR = 0.65, 95%CI 0.19~2.22, n.s.), and sagittal alignment of femoral component (RR = 0.73, 95%CI 0.38~1.41, n.s.). A reduced blood loss was associated with the use of the extramedullary guide (MD = -120.34, 95%CI -210.08~-30.59, P = 0.009). No significant difference in operation time was noted between the two groups (MD = 1.41, 95%CI -1.82~4.64, n.s.).
conclusionsNeither extramedullary nor intramedullary femoral alignment is more accurate than the other in facilitating the femoral cut in total knee arthroplasty. Use of the extramedullary guide results in less blood loss and exhibits a similar operation time as compared with the intramedullary guide.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.