A New Method for Evaluation of Patellar Height and the Position of the Joint Line Before and After Total Knee Arthroplasty

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2020 Nov 22

PMID 33220714

Citations 5

Authors

Hua Han

Xiaohui Zhang

Affiliations

Soon will be listed here.

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 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.

Citing Articles

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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Joint line position change in primary total knee arthroplasty: a radiographic analysis comparing conventional and robotic techniques.

Cozzarelli N, DeSimone C, DAmore T, Sherman M, Lonner J Int Orthop. 2023; 48(4):1023-1030.

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Evaluation of patella height in native knees and arthroplasty: an instructional review.

Konrads C, Schreiner A, Cober S, Schull D, Ahmad S, Alshrouf M SICOT J. 2022; 8:36.

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Kamei G, Ishibashi S, Yoshioka K, Sakurai S, Inoue H, Mochizuki Y Knee Surg Relat Res. 2022; 34(1):10.

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Patellar height after unicompartmental knee arthroplasty: comparison between fixed and mobile bearing.

DAmbrosi R, Buda M, Nuara A, Mariani I, Scelsi M, Valli F Arch Orthop Trauma Surg. 2021; 142(11):3449-3460.

PMID: 34669039 DOI: 10.1007/s00402-021-04183-6.

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