Patellar Height After Total Knee Arthroplasty: Comparison of 3 Methods

Cabral, Filipe; Sousa‐Pinto, Bernardo; Pinto, Rui; Torres, João

doi:10.1016/j.arth.2016.07.013

Cited by 28 publications

(33 citation statements)

References 17 publications

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“…As an intramedullary reference, the tibial shaft axis can theoretically provide a constant landmark compared to marginal counterparts, especially during tibial rotating subsequent to knee exion. In present work, no signi cant difference was found between pre-operation and post-operative two weeks for AP and IS indices, consistently with the short-term results of IS index in previous reports [3,31]. Hence, we speculate that this result is reasonable, because the T1 point on the tibial shaft axis, which located at the level of the tip of the bular head, maintains a relatively constant distance from the tibiofemoral surface affected by the surgical operation.…”

Section: Discussionsupporting

confidence: 92%

“…Osteophytes were excluded during the measurements. After TKA, the tibial plateau was de ned as the tangent line of the distal femoral component parallel to tibial osteotomy plane, as conducted by Rogers [6] and Cabral et al [3] (Fig. 1B and D).…”

Section: Description Of the Methods For Assessing Patellar Heightmentioning

confidence: 99%

“…Total knee arthroplasty (TKA) is the gold standard for the treatment of advanced knee osteoarthritis [1,2]. However, among the postoperative complications of TKA, patellofemoral pain, knee instability, and reduction of movement range are still common, which resulted from abnormal patellar height to some extent [3,4]. Patella alta or patella baja is considered to be one of the indicators of poor clinical outcomes after TKA.…”

Section: Introductionmentioning

confidence: 99%

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A new method for evaluation of patellar height and the position of the joint line before and after total knee arthroplasty

Han

Zhang

2020

Preprint

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Abstract Background: The measurement of patellar height and restoration of the natural position of the joint line are crucial to total knee arthroplasty (TKA). However, there remains a lack of consensus on an optimal measurement method to associate the patellar height with the joint line position. The objective of this study was to introduce a new method and validate the application in TKA both preoperatively and postoperatively.Methods: Instead of taking marginal landmarks as the tibial references, the tibial shaft axis was used to construct the new measurement method, which comprises the axis-patella (AP), joint axis-patella (jAP) indices and joint line height (JLH). Patellar heights were measured using the Insall-Salvati (IS), modified Insall-Salvati (mIS), Blackburne-Peel (BP), Caton-Deschamps (CD) indices, and the new method in 175 knees both preoperatively and postoperatively. Intraclass correlation coefficients and Pearson’s correlation analysis were respectively used to evaluate the reliabilities and correlations.Results: There was good correlation between the proposed method and the mIS, CD, and BP indices. High inter-observer reproducibility was found for AP (preoperative and postoperative 0.83), jAP (preoperative 0.82; postoperative 0.86) indices and JLH (preoperative 0.88; postoperative 0.95). High intra-observer repeatability was also found for AP (preoperative 0.85; postoperative 0.87), jAP (preoperative 0.83; postoperative 0.87) indices and JLH (preoperative 0.80; postoperative 0.92). Conclusions: The new method is reliable for measuring patellar height before and after TKA, providing an alternative to distinguish between true and pseudo patella baja. Furthermore, JLH can be applied to assess and restore the joint line position in TKA.

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Section: Discussionsupporting

confidence: 92%

Section: Description Of the Methods For Assessing Patellar Heightmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A new method for evaluation of patellar height and the position of the joint line before and after total knee arthroplasty

Han

Zhang

2020

Preprint

View full text Add to dashboard Cite

show abstract

Section: Description Of the Methods For Assessing Patellar Heightmentioning

confidence: 99%

“…However, among the postoperative complications of TKA, patellofemoral pain, knee instability, and reduction of movement range are still common, which resulted from abnormal patellar height to some extent [3,4].…”

Section: Introductionmentioning

confidence: 99%

A new method for evaluation of patellar height and the position of the joint line before and after total knee arthroplasty

Han

Zhang

2020

Preprint

View full text Add to dashboard Cite

Background: The measurement of patellar height and restoration of the natural position of the joint line are crucial to total knee arthroplasty (TKA). However, there remains a lack of consensus on an optimal measurement method to associate the patellar height with the joint line position. The objective of this study was to introduce a new method and validate the application in TKA both preoperatively and postoperatively.Methods: Instead of taking marginal landmarks as the tibial references, the tibial shaft axis was used to construct the new measurement method, which comprises the axis-patella (AP), joint axis-patella (jAP) indices and joint line height (JLH). Patellar heights were measured using the Insall-Salvati (IS), modified Insall-Salvati (mIS), Blackburne-Peel (BP), Caton-Deschamps (CD) indices, and the new method in 175 knees both preoperatively and postoperatively. Intraclass correlation coefficients and Pearson’s correlation analyses were respectively used to evaluate the reliabilities and correlations.Results: There were good correlations between the proposed method and the mIS, CD, and BP indices. High inter-observer reproducibility was found for AP (preoperative and postoperative 0.83), jAP (preoperative 0.82; postoperative 0.86) indices and JLH (preoperative 0.88; postoperative 0.95). High intra-observer repeatability was also found for AP (preoperative 0.85; postoperative 0.87), jAP (preoperative 0.83; postoperative 0.87) indices and JLH (preoperative 0.80; postoperative 0.92).Conclusions: The new method is reliable for measuring patellar height before and after TKA, providing an alternative to distinguish between true and pseudo patella baja. Furthermore, JLH can be applied to assess and restore the joint line position in TKA.

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