Calculating position of joint line of knee using various radiological parameters based on Indian population

Abstract

Restoration of the joint line of the knee is an important technical goal of a total knee arthroplasty. Failure to restore the joint line of the knee to anatomical position can lead to mid-flexion instability, a reduction in range of motion, impingement of the patellar tendon against the tibial tray, and gap imbalance. The presence and integrity of bone and soft tissue landmarks makes restoration of the joint line Successful. Restoration of the joint line both difficult and unreliable especially in revision TKA, where the necessary landmarks are often missing or obscured. Numerous methods, ranging from relative references, to absolute distances have been described for joint line restoration, yet a lack of consensus remains. The aim this study was to determine a reproducible, quantitative relationship between position of joint line and identifiable anatomical landmarks in Indian population after studying randomly selected Indian population. Results of our study indicate that Femoral diameters are statistically different for Sexes while Tibial diameters are not, IMD is 1.75 times LFJL,CTD is 2.7 times PTFJL, PCO is more important in predicting range of motion in TKA. PCJL:FD and IED:LEJL are also significant.

Does robotic technology successfully restore the joint line after total knee arthroplasty? A retrospective analysis

“…Restoring the joint line to the near-normal results in improved knee scores [9]. Amarnath et al [4] mentioned that conventional methods lack accuracy and lead to the mal-positioned and frequently elevated joint line. Elevation of the joint line leads to many problems such as anterior knee pain, reduced range of motion (ROM), patella baja, mid-flexion instability [14], patellar tendon impingement, and accelerated wear [1].…”

“…Hence, it is important to restore the joint line near normal for better outcomes of the procedure. Several methods have been described for analyzing the joint line [4]. Earlier studies attempted to analyze the joint line, taking into account various bone and soft tissue landmarks and ratios [3,4,[15][16][17][18].…”

“…Several methods have been described for analyzing the joint line [4]. Earlier studies attempted to analyze the joint line, taking into account various bone and soft tissue landmarks and ratios [3,4,[15][16][17][18]. Rajagopal et al [16] and Mountney et al [17] suggested that the ratio between inter-epicondylar distance (IED) and perpendicular to the joint line from the medial epicondyle or lateral epicondyle is constant and is about 3.0.…”

“…The PTFJ can be identified as the center of the horizontal portion of the proximal tibiofibular joint [ 3 ]. If it is not visible due to fibular rotation, it is at the intersection of the lateral prominence of the fibular head and the fibular styloid [ 3 , 4 ]. LE is the most prominent bony point on the lateral distal femur, from which the lateral collateral ligament originates [ 3 , 4 ].…”

“…If it is not visible due to fibular rotation, it is at the intersection of the lateral prominence of the fibular head and the fibular styloid [ 3 , 4 ]. LE is the most prominent bony point on the lateral distal femur, from which the lateral collateral ligament originates [ 3 , 4 ]. The joint line (JL) is represented in the AP X-ray image by a line drawn tangentially to the distal surface of the femoral prosthesis.…”