The adductor tubercle as an important landmark to determine the joint line level in total knee arthroplasty: from radiographs to surgical theatre

Iacono, Francesco; Raspugli, Giovanni Francesco; Bruni, Danilo; Filardo, Giuseppe; Zaffagnini, Stefano; Luetzow, William F.; Presti, Mirco Lo; Akkawi, Ibrahim; Muccioli, Giulio Maria Marcheggiani; Marcacci, Maurilio

doi:10.1007/s00167-013-2809-0

Cited by 23 publications

(32 citation statements)

References 18 publications

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“…[ 14 ] and Iacono et al . [ 15 16 ] concluded that the femoral adductor tubercle was an accurate and stable anatomical landmark for measurement of knee JL position, and that its position was not affected by knee flexion or extension. Weber concluded that internal or external rotation were no influence on measurement result if the angle was <10°.…”

Section: Discussionmentioning

confidence: 99%

Effect of Joint Line Elevation after Posterior-stabilized and Cruciate-retaining Total Knee Arthroplasty on Clinical Function and Kinematics

Songjie

Zhou

Jiang

et al. 2015

Chinese Medical Journal

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Background:Joint line (JL) is a very important factor for total knee arthroplasty (TKA) to restore. The objective of this study was to evaluate the early clinical and kinematic results of TKAs with posterior-stabilized (PS) or cruciate retaining (CR) implants in which the JL was elevated postoperatively.Methods:Data were collected from patients who underwent TKA in our department between April 2011 and April 2014. The patients were divided into two groups based on the prosthesis they received (PS or CR). At 1-year postoperatively, clinical outcomes were evaluated by the American Knee Society (AKS) knee score, AKS function score, and patella score. In vivo kinematic analysis after TKA was performed on all patients and a previously validated three-dimensional to two-dimensional image registration technique was used to obtain the kinematic data. Anteroposterior (AP) translation of the medial and lateral femoral condyles, and axial rotation relative to the tibial plateau, were analyzed. The data were assessed using the Mann–Whitney test.Results:At time of follow-up, there were differences in the AKS knee scores (P = 0.005), AKS function scores (P = 0.025), patella scores (P = 0.015), and postoperative range of motions (P = 0.004) between the PS group and the CR group. In the PS group, the magnitude of AP translation for the medial and lateral condyle was 4.9 ± 3.0 mm and 12.8 ± 3.3 mm, respectively. Axial rotation of the tibial component relative to the femoral component was 12.9 ± 4.5°. In the CR group, the magnitude of AP translation for the medial and lateral condyle was 4.3 ± 3.5 mm and 7.9 ± 4.2 mm, respectively. The axial rotation was 6.7 ± 5.9°. There were statistically different between PS group and CR group in kinematics postoperatively.Conclusion:Our results demonstrate that postoperative JL elevation had more adverse effects on the clinical and kinematic outcomes of CR TKAs than PS TKAs.

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Section: Discussionmentioning

confidence: 99%

Effect of Joint Line Elevation after Posterior-stabilized and Cruciate-retaining Total Knee Arthroplasty on Clinical Function and Kinematics

Songjie

Zhou

Jiang

et al. 2015

Chinese Medical Journal

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“…At the femoral side, the change of the joint height of the femur was measured based on a method previously described. 17 The perpendicular distance between the adductor tubercle as the distal point on the medial condylar slope of the femur and the joint line was measured (‘distance D’). The joint line down the femur (JLDF) was defined as the difference between pre- and post-operative distance D.…”

Section: Methodsmentioning

confidence: 99%

Correction of coronal alignment correlates with reconstruction of joint height in unicompartmental knee arthroplasty

Kuwashima

Okazaki

Tashiro

et al. 2015

Bone & Joint Research

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ObjectivesBecause there have been no standard methods to determine pre-operatively the thickness of resection of the proximal tibia in unicompartmental knee arthroplasty (UKA), information about the relationship between the change of limb alignment and the joint line elevation would be useful for pre-operative planning. The purpose of this study was to clarify the correlation between the change of limb alignment and the change of joint line height at the medial compartment after UKA.MethodsA consecutive series of 42 medial UKAs was reviewed retrospectively. These patients were assessed radiographically both pre- and post-operatively with standing anteroposterior radiographs. The thickness of bone resection at the proximal tibia and the distal femur was measured radiographically. The relationship between the change of femorotibial angle (δFTA) and the change of joint line height, was analysed.ResultsThe mean pre- and post-operative FTA was 180.5° (172.2° to 184.8°) and 175.0° (168.5° to 178.9°), respectively. The mean δFTA was 5.5° (2.3° to 10.1°). The joint line elevation of the tibia (JLET) was 4.4 mm (2.1 to 7.8). The δFTA was correlated with the JLET (correlation coefficient 0.494, p = 0.0009).ConclusionsThis study indicated that there is a significant correlation between the change of limb alignment and joint line elevation. This observation suggests that it is possible to know the requirement of elevation of the joint line to obtain the desired correction of limb alignment, and to predict the requirement of bone resection of the proximal tibia pre-operatively.Cite this article: Bone Joint Res 2015;4:128–133

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“…Femoral rotation and joint line displacement were assessed. Femorotibial joint line height restoration was determined radiographically using the ratio of the adductor tubercle to joint line distance and the femoral width [38].…”

Section: Methodsmentioning

confidence: 99%

Gap-balancing technique combined with patient-specific instrumentation in TKA

Hommel

Perka

2015

Arch Orthop Trauma Surg

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The adductor tubercle as an important landmark to determine the joint line level in total knee arthroplasty: from radiographs to surgical theatre

Abstract: Case series, Level IV.

Cited by 23 publications

References 18 publications

Effect of Joint Line Elevation after Posterior-stabilized and Cruciate-retaining Total Knee Arthroplasty on Clinical Function and Kinematics

Effect of Joint Line Elevation after Posterior-stabilized and Cruciate-retaining Total Knee Arthroplasty on Clinical Function and Kinematics

Correction of coronal alignment correlates with reconstruction of joint height in unicompartmental knee arthroplasty

Gap-balancing technique combined with patient-specific instrumentation in TKA

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