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. 2020 Sep 14;2(1):27.
doi: 10.1186/s42836-020-00046-4.

Joint line reestablishment in revision total knee arthroplasty

Mustafa Çınar Akça  1 , Yavuz Akalın  1 , Nazan Çevik  1 , İsmail Gökhan Şahin  2 , Özgür Avcı  1 , Alpaslan Öztürk  3
Affiliations

Joint line reestablishment in revision total knee arthroplasty

Mustafa Çınar Akça et al. Arthroplasty. .

Abstract

Background: In this study, the traditional "Anatomical Landmark-Distance Method (AL-DM)" in the formation of joint line (JL) was compared with "Adductor Tubercle-Ratios method" (AT-RM), and the effect of reestablishment of JL on clinical and functional outcomes were evaluated.

Materials and methods: 16 revision total knee arthroplasties (rTKAs) were performed by using "AT-RM" (group 1) and 16 rTKA by using "AL-DM" (group 2) in our clinic between 2015 and 2018. The data were prospectively collected and a total of 32 knees of 31 patients were analyzed. At the final follow-up, knee functions were evaluated by using Knee Society Score (KSS) knee and function, Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, Short Form-36 (SF-36) questionnaires and physical examinations.

Results: Postoperative flexion arc was higher in Group 1. KSS knee and function scores were better in group 1. In group1, JL was reestablished successfully in all revision rTKAs in terms of ATJL and the tibial tubercle TT-JL ratios. The improvement in KSS knee and function scores and WOMAC scores were also better in group 1. Measurements showed that the improvement in KSS scores increased as AT-JL and TT-JL distances approached the calculated values.

Conclusion: "AT-RM" was shown to be superior to the traditional distance method in terms of JL reestablishment. Functional results and patient satisfaction increased when JL was reestablished.

Keywords: Adductor tubercle; Anatomical landmark; Distance method; Joint line (JL); Ratios method; Tibial tubercle; rTKA.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
a. Kirshner wire placed at the insertion of the Adductor Magnus muscle (Adductor Tubercule). b. Joint line restorations with femoral trial prothesis according to calculations from AT
Fig. 2
Fig. 2
Joint line restoration with femoral femoral trial prothesis according to calculations. a. ME-JL. b. LE-JL
Fig. 3
Fig. 3
Posterior joint line restorations with femoral trial prothesis according to calculations. a. ME-PJL. b. LE-PJL
Fig. 4
Fig. 4
JL and PJL restoration with trial prothesis using augments
Fig. 5
Fig. 5
a. Measuring the anterior-posterior length of the tibia. b. JL restoration according to TT
See this image and copyright information in PMC

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