The Imperial Joint Line Congruency Measurement is a valuable tool in total knee arthroplasty

Popat, Ravi; Dhillon, Kieran; Mahapatra, Piyush; Khan, Hasaan; Nathwani, Dinesh

doi:10.1371/journal.pone.0257325

Cited by 4 publications

(5 citation statements)

References 19 publications

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“…The seminal work by Figgie et al demonstrated an average change in joint line of 8.9mm following primary conventional TKA. The measuring technique has subsequently been demonstrated to have relatively poor inter and intra-observer reliability [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…Due to the different methods used to measure joint line height in the literature, it is difficult to compare our findings with those of other authors. Previous work has demonstrated the accuracy, precision and reliability of the measurement technique utilised in this study [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…Computer software Osirix (Pixmeo, Bernex, Switzerland) was used to perform measurements. Joint line height was measured on pre-operative and post-operative radiographs using the Imperial Joint Line Congruency Measurement (IJLCM) Technique [ 22 ] (Figs 1 and 2 ). Posterior offset was measured using the technique described by Bellemans et al [ 23 ] ( Fig 3 ).…”

Section: Methodsmentioning

confidence: 99%

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Improved joint line and posterior offset restoration in primary total knee replacement using a robotic-assisted surgical technique: An international multi-centre retrospective analysis of matched cohorts

et al. 2022

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Background Accurate restoration of joint line height and posterior offset in primary Total Knee Arthroplasty (TKA) have been shown to be important factors in post-operative range of movement and function. The aim of this study was to assess the accuracy of joint line and posterior offset restoration in a group of patients that underwent robotic-assisted TKA (raTKA). A matched cohort of patients that underwent a TKA using a conventional jig-based technique was assessed for comparison. The null hypothesis was that there would be no difference between groups. Methods This study was a retrospective analysis of a cohort of 120 patients with end-stage knee osteoarthritis that received a TKA using the Navio Surgical System (n = 60), or Conventional manual TKA (n = 60). Procedures were performed between 1 January 2019 and 1 October 2019 at six different centres. Joint line height and posterior offset was measured pre-operatively and post-operatively on calibrated weight bearing plain radiographs of the knee. Two observers performed measurements using validated measuring tools. A BMI and age-matched cohort of patients that underwent TKA using a conventional technique in the same six centres were assessed for comparison. Mean values, standard deviations and confidence intervals are presented for change and absolute change in joint line height and posterior offset. Student’s t-test was used to compare the changes between techniques. Results Patients that underwent robotic-assisted TKA had joint line height and posterior offset restored more accurately than patients undergoing TKA using a conventional technique. Average change from pre-operative measurement in joint line height using raTKA was -0.38mm [95% CI: -0.79 to 0.03] vs 0.91 [0.14 to 1.68] with the conventional technique. Average absolute change in joint line height using raTKA was 1.96mm [1.74 to 2.18] vs 4.00mm [3.68 to 4.32] with the conventional technique. Average change in posterior offset using raTKA was 0.08mm [-0.40 to 0.56] vs 1.64mm [2.47 to 0.81] with the conventional technique. Average absolute change in posterior offset with raTKA was 2.19mm [1.92 to 2.46] vs 4.24mm [3.79 to 4.69] with the conventional technique. There was a significant difference when comparing absolute change in joint line height and posterior offset between groups (p<0.01). Conclusion Robotic-assisted primary TKA restores the joint line height and posterior offset more accurately than conventional jig-based techniques.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Improved joint line and posterior offset restoration in primary total knee replacement using a robotic-assisted surgical technique: An international multi-centre retrospective analysis of matched cohorts

et al. 2022

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“…In our study, shown significant posterior condylar offset deviation in CMTKA higher than RATKA group but no significant difference in clinical outcome. Correlated to previous study, Ravi Popat et al [16] , report that deviation of posterior condylar offset in RATKA was significantl lower than CMTKA (2.19 mm. vs 4.24 mm.).…”

Section: Discussionsupporting

confidence: 64%

“…Measurement) [16,31] . The difference in joint line height was calculated by postoperative joint line height (mm.)…”

Section: Joint Line Height Was Measured By Ijlcm Technique (Imperial ...mentioning

confidence: 99%

Short-term clinical & radiologic outcomes of Imageless - robotic assisted total knee arthroplasty versus conventional total knee arthroplasty in Thabo Crown Prince Hospital: Retrospective cohort study

Sriphirom,

Wongyongsilp,

Wicharn

EPiC Series in Health Sciences

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Introduction: Robotic assisted total knee arthroplasty (RATKA) was proven that improved component position, ligament balanced and decreased outlier leading to improved clinical results and implant survivorship. Aiming of this study is comparison of short-term clinical and radiologic outcomes between RATKA versus conventional TKA (CMTKA) in Thabo Crown Prince Hospital, Thailand.Methods: Retrospective cohort study by single surgeon, from July 2020 to August 2022 compared 51 RATKA and 49 CMTKA. Baseline data and short-term clinical outcomes including knee society score (KSS), operative time, estimated blood loss (EBL), length of stay (LOS), complications and radiologic outcomes were collected at postoperatively 3 months follow up.Results: There was no statistically significant difference in KSS, EBL, LOS and complications between RATKA and CMTKA (P < 0.05). Operative time was significant greater in RATKA (138 vs. 162 min, P < 0.05). Radiologic outcomes in CMTKA, posterior condylar Offset, posterior condylar deviation, tibial slope was significant higher (P < 0.05). In subgroup analysis, patients with post operative tibial slope ≥ 7° (poor clinical outcomes) in CMTKA significantly higher than in RATKA (P = 0.021).Conclusions: Imageless - robotic assisted total knee arthroplasty demonstrated that more benefit in posterior condylar offset and posterior tibial slope restoration and seem to be better in short-term clinical outcomes.

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The ROSA knee robotic system demonstrates superior precision in restoring joint line height and posterior condylar offset compared to conventional manual TKA: a retrospective case–control study

Gamie,

Paparoidamis,

Milonakis

et al. 2024

Eur J Orthop Surg Traumatol

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Purpose Variations in total knee arthroplasty (TKA) joint line height may lead to complications such as pain and altered joint mechanics, while posterior condylar offset (PCO) can influence knee stability. Methods Single-centre, single-surgeon retrospective analysis from December 2019 to May 2023 investigated primary unilateral TKA (Nexgen Legacy, Zimmer Biomet) in patients with knee osteoarthritis, using ROSA robotic system (raTKA) or conventional manual technique (mTKA). Joint line height and PCO were measured and compared in 182 raTKA and 144 mTKA patients. Results The groups were matched in age (p = 0.847) and sex distribution (p = 0.2). Excellent interobserver agreement (ICC ≥ 0.9). RaTKA mean joint line height difference was − 0.0001 mm (± 3.48, 95% CI − 0.509, 0.509) (p = 0.523), − 0.951 mm for mTKA (± 4.33, 95% CI − 1.664, − 0.237) (p = 0.009). RaTKA mean PCO difference was 0.52 mm (± 2.45, 95% CI 0.160, 0.880) (p = 0.005), 1.15 mm for mTKA (± 4.01, 95% CI – 1.496, 1.818) (p < 0.001). Mean difference in joint line height of 0.95 mm between groups was significant (p = 0.027), and for PCO, it was 0.63 mm, demonstrating tendency towards significance (p = 0.08). Mean absolute value in joint line height difference between groups was not significant (p = 0.235) but highly significant for PCO (p < 0.001). Conclusion The ROSA knee robotic system can more accurately restore joint line height and PCO compared to conventional manual TKA. The improved degree of precision raTKA offers may be a vehicle for better Patient-Reported Outcome Measures, but further correlational studies are required.

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The Imperial Joint Line Congruency Measurement is a valuable tool in total knee arthroplasty

Cited by 4 publications

References 19 publications

Improved joint line and posterior offset restoration in primary total knee replacement using a robotic-assisted surgical technique: An international multi-centre retrospective analysis of matched cohorts

Improved joint line and posterior offset restoration in primary total knee replacement using a robotic-assisted surgical technique: An international multi-centre retrospective analysis of matched cohorts

Short-term clinical & radiologic outcomes of Imageless - robotic assisted total knee arthroplasty versus conventional total knee arthroplasty in Thabo Crown Prince Hospital: Retrospective cohort study

The ROSA knee robotic system demonstrates superior precision in restoring joint line height and posterior condylar offset compared to conventional manual TKA: a retrospective case–control study

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