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Comparison of extramedullary versus intramedullary referencing for tibial component alignment in total ankle arthroplasty.

Publication ,  Journal Article
Adams, SB; Demetracopoulos, CA; Viens, NA; DeOrio, JK; Easley, ME; Queen, RM; Nunley, JA
Published in: Foot Ankle Int
December 2013

BACKGROUND: The majority of total ankle arthroplasty (TAA) systems use extramedullary alignment guides for tibial component placement. However, at least 1 system offers intramedullary referencing. In total knee arthroplasty, studies suggest that tibial component placement is more accurate with intramedullary referencing. The purpose of this study was to compare the accuracy of extramedullary referencing with intramedullary referencing for tibial component placement in total ankle arthroplasty. METHODS: The coronal and sagittal tibial component alignment was evaluated on the postoperative weight-bearing anteroposterior (AP) and lateral radiographs of 236 consecutive fixed-bearing TAAs. Radiographs were measured blindly by 2 investigators. The postoperative alignment of the prosthesis was compared with the surgeon's intended alignment in both planes. The accuracy of tibial component alignment was compared between the extramedullary and intramedullary referencing techniques using unpaired t tests. Interrater and intrarater reliabilities were assessed with intraclass correlation coefficients (ICCs). RESULTS: Eighty-three tibial components placed with an extramedullary referencing technique were compared with 153 implants placed with an intramedullary referencing technique. The accuracy of the extramedullary referencing was within a mean of 1.5 ± 1.4 degrees and 4.1 ± 2.9 degrees in the coronal and sagittal planes, respectively. The accuracy of intramedullary referencing was within a mean of 1.4 ± 1.1 degrees and 2.5 ± 1.8 degrees in the coronal and sagittal planes, respectively. There was a significant difference (P < .001) between the 2 techniques with respect to the sagittal plane alignment. Interrater ICCs for coronal and sagittal alignment were high (0.81 and 0.94, respectively). Intrarater ICCs for coronal and sagittal alignment were high for both investigators. CONCLUSIONS: Initial sagittal plane tibial component alignment was notably more accurate when intramedullary referencing was used. Further studies are needed to determine the effect of this difference on clinical outcomes and long-term survivability of the implants. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

Duke Scholars

Published In

Foot Ankle Int

DOI

EISSN

1944-7876

Publication Date

December 2013

Volume

34

Issue

12

Start / End Page

1624 / 1628

Location

United States

Related Subject Headings

  • Tibia
  • Retrospective Studies
  • Prosthesis Fitting
  • Orthopedics
  • Joint Prosthesis
  • Humans
  • Bone Malalignment
  • Arthroplasty, Replacement, Ankle
  • 4207 Sports science and exercise
  • 4201 Allied health and rehabilitation science
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Adams, S. B., Demetracopoulos, C. A., Viens, N. A., DeOrio, J. K., Easley, M. E., Queen, R. M., & Nunley, J. A. (2013). Comparison of extramedullary versus intramedullary referencing for tibial component alignment in total ankle arthroplasty. Foot Ankle Int, 34(12), 1624–1628. https://doi.org/10.1177/1071100713505534
Adams, Samuel B., Constantine A. Demetracopoulos, Nicholas A. Viens, James K. DeOrio, Mark E. Easley, Robin M. Queen, and James A. Nunley. “Comparison of extramedullary versus intramedullary referencing for tibial component alignment in total ankle arthroplasty.Foot Ankle Int 34, no. 12 (December 2013): 1624–28. https://doi.org/10.1177/1071100713505534.
Adams SB, Demetracopoulos CA, Viens NA, DeOrio JK, Easley ME, Queen RM, et al. Comparison of extramedullary versus intramedullary referencing for tibial component alignment in total ankle arthroplasty. Foot Ankle Int. 2013 Dec;34(12):1624–8.
Adams, Samuel B., et al. “Comparison of extramedullary versus intramedullary referencing for tibial component alignment in total ankle arthroplasty.Foot Ankle Int, vol. 34, no. 12, Dec. 2013, pp. 1624–28. Pubmed, doi:10.1177/1071100713505534.
Adams SB, Demetracopoulos CA, Viens NA, DeOrio JK, Easley ME, Queen RM, Nunley JA. Comparison of extramedullary versus intramedullary referencing for tibial component alignment in total ankle arthroplasty. Foot Ankle Int. 2013 Dec;34(12):1624–1628.
Journal cover image

Published In

Foot Ankle Int

DOI

EISSN

1944-7876

Publication Date

December 2013

Volume

34

Issue

12

Start / End Page

1624 / 1628

Location

United States

Related Subject Headings

  • Tibia
  • Retrospective Studies
  • Prosthesis Fitting
  • Orthopedics
  • Joint Prosthesis
  • Humans
  • Bone Malalignment
  • Arthroplasty, Replacement, Ankle
  • 4207 Sports science and exercise
  • 4201 Allied health and rehabilitation science