Total Knee Arthroplasty, All-in-One versus Four-in-One Femoral Cutting Jig System: A Comparison Study

Total knee arthroplasty (TKA) is often indicated for end-stage knee osteoarthritis management. The posterior-stabilized (PS) implant is one of the TKA implants with various component designs, including femoral component cutting jigs. However, little is known about how the differences in cutting jig designs affect the outcomes. This study aims to compare the radiographic and functional outcomes of the patients who underwent cemented TKA using all-in-one and four-in-one femoral component PS implants.

A retrospective comparative study assessed patients who underwent cemented TKA using PS implants from 2018 to 2019. The patients were divided into all-in-one and four-in-one groups. Demographic data, surgery duration, postoperative radiological findings after one week, and functional outcomes after two years were collected and compared.

A total of 96 patients were included in the study, 55 patients were in all-in-one sample, and 41 patients were in four-in-one sample. The majority of the patients in both groups were female, aged >60 years old, overweight (BMI ≥ 25), and presented with an ASA score of II. We found significantly shorter surgery duration in the all-in-one group compared to the four-in-one group (128.00 ± 36.24 vs. 210.61 ± 57.54, p=0.000). The four-in-one group and the all-in-one group showed the insignificant difference in α, β, δ, and γ angles (p=0.476, 0.273, 0.594, and 0.818). The functional outcomes (SF-12, KSS, and KOOS) showed insignificant differences.

There is no differentiation for the postsurgery functional and radiological outcomes between all-in-one and four-in-one implants.