The Influence of the Posterior Cruciate Ligament and Component Design on Joint Line Position After Primary Total Knee Arthroplasty

Snider, Matthew; MacDonald, Steven J.

doi:10.1016/j.arth.2008.08.009

Cited by 44 publications

(47 citation statements)

References 8 publications

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“…The Snider and Macdonald method of measuring the joint line has been validated using the tibial tubercle on a lateral radiograph, which is the other commonly used method of determining the joint line. 7 The tip of the fibula was an easier landmark to use than the tibial tubercle as the precise location of the tubercle on radiographs is often hard to determine. All radiographs where measured three times by a single researcher (SB).…”

Section: Methodsmentioning

confidence: 99%

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Joint line position correlates with function after primary total knee replacement

Babazadeh

Dowsey

Swan

et al. 2011

The Journal of Bone and Joint Surgery. British volume

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The role of computer-assisted surgery in maintaining the level of the joint in primary knee joint replacement (TKR) has not been well defined. We undertook a blinded randomised controlled trial comparing joint-line maintenance, functional outcomes, and quality-of-life outcomes between patients undergoing computer-assisted and conventional TKR. A total of 115 patients were randomised (computer-assisted, n = 55; conventional, n = 60). Two years post-operatively no significant correlation was found between computer-assisted and conventional surgery in terms of maintaining the joint line. Those TKRs where the joint line was depressed post-operatively improved the least in terms of functional scores. No difference was detected in terms of quality-of-life outcomes. Change in joint line was found to be related to change in alignment. Change in alignment significantly affects change in joint line and functional scores.

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Section: Methodsmentioning

confidence: 99%

“…16 This score was found to be significantly better in knees with a maintained joint line in one study, 1 but not in another. 7 The relationship between joint line and quality of life, using, for example, the Short-Form 12 (SF-12) survey, 17 is also lacking.…”

mentioning

confidence: 99%

Joint line position correlates with function after primary total knee replacement

Babazadeh

Dowsey

Swan

et al. 2011

The Journal of Bone and Joint Surgery. British volume

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“…Joint line position following primary and revision TKA has been shown to affect a patient's clinical outcome. [3][4][5][6][7] Excessive elevation of the joint line (> 8 mm), and numerous pathologic and implant design factors, has been associated with knee pain, instability, and decreased range of motion due to patellar impingement. 4 In conjunction with restoring the distal joint line position, an appropriately sized femoral component with correct posterior condylar offset and posterior augments is recommended to balance a revision TKA and to restore the joint line posteriorly.…”

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confidence: 99%

Joint Line Restoration in a Contemporary Revision Knee System

et al. 2014

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We investigated a new revision total knee arthroplasty device and associated instrumentation to determine if it could reduce intraoperative complexity and restore the joint line through the arc of motion. In a prospective multicenter study, a total of 95 consecutive patients undergoing a revision knee arthroplasty were evaluated. Medical history, functional health scores, and intraoperative data were collected. The joint line was restored to 28 mm ± 5 mm in full extension and 90-degree flexion. Significant improvements were noted in all functional and general health scores. The anatomic boss position may allow for a reduction in instrumentation, as the need for femoral offset adapters was limited. Joint line restoration with proper posterior condylar offset correlated with positive functional outcomes.

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“…52 However, more recent studies comparing cruciate-sacrificing and -retaining TKRs 58,59 have failed to identify a post-operative difference in joint line position, and this doctrine has been challenged. 59 Nevertheless, when the surgeon cannot maintain the joint line, thereby giving rise to either an overly lax posterior cruciate ligament or an overly tight posterior cruciate ligament with subsequent posterior edge loading and increased tibiofemoral contact, a cruciate-substituting design is advocated. 59 The height of the joint line is the perpendicular distance from the superior margin of the tibial tubercle to the weight-bearing parallel surface of the tibial plateau or components as measured on a lateral radiograph (Fig.…”

Section: Joint Linementioning

confidence: 99%

The radiological assessment of total and unicompartmental knee replacements

Sarmah

Patel

Hossain

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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Radiological assessment of total and unicompartmental knee replacement remains an essential part of routine care and follow-up. Appreciation of the various measurements that can be identified radiologically is important. It is likely that routine plain radiographs will continue to be used, although there has been a trend towards using newer technologies such as CT, especially in a failing knee, where it provides more detailed information, albeit with a higher radiation exposure. The purpose of this paper is to outline the radiological parameters used to evaluate knee replacements, describe how these are measured or classified, and review the current literature to determine their efficacy where possible.

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The Influence of the Posterior Cruciate Ligament and Component Design on Joint Line Position After Primary Total Knee Arthroplasty

Cited by 44 publications

References 8 publications

Joint line position correlates with function after primary total knee replacement

Joint line position correlates with function after primary total knee replacement

Joint Line Restoration in a Contemporary Revision Knee System

The radiological assessment of total and unicompartmental knee replacements

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