ArticleInternational orthopaedics2014
Accuracy of bony landmarks for restoring the natural joint line in revision knee surgery: an MRI study.
Article in International orthopaedics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Impact of Joint Line Displacement on Function and Quality of Life After Primary Total Knee Arthroplasty.Journal of clinical medicine · 2026Article
- CT-based estimation of medial and lateral femoral joint lines in extension and flexion: A large three-dimensional validation study.Journal of experimental orthopaedics · 2026Article
- Standardizing Joint-Line determination on anteroposterior knee radiographs: multicenter validation of the adductor ratio and a novel composite index in 3000 knees.Archives of orthopaedic and trauma surgery · 2026Article
- Estimation of adductor ratio in the Indian population: Is it a reliable indicator for recreating joint line of the knee?Journal of clinical orthopaedics and trauma · 2025Article
- Is Native Joint Line More Accurately Restored with Robotic Assisted Total Knee Arthroplasty than with Conventional Instruments?Journal of orthopaedic case reports · 2025Article
- An MRI-Derived Formula for Estimating the Native Joint Line Position in the Presence of Distal Femoral Bone Loss.Cureus · 2024Article
- Navigation of femoral and popliteal artery around the knee with CT angiography: implications for surgical interventions.Surgical and radiologic anatomy : SRA · 2023Article
- Identification of the joint line in revision total knee arthroplasty using a multiple linear regression model: a cadaveric study.Archives of orthopaedic and trauma surgery · 2023Article
- Knee joint line related to bony landmarks of the knee: a radiologic study in a Thai population.Knee surgery & related research · 2022Article
- Accuracy of joint line restoration based on three-dimensional registration of the contralateral tibial tuberosity and the fibular tip.Journal of experimental orthopaedics · 2021Article
- The reliability of adductor tubercle as an anatomical landmark for joint line restoration in revision knee arthroplasty: a systematic review.Annals of translational medicine · 2021Review
- Joint line reestablishment in revision total knee arthroplasty.Arthroplasty (London, England) · 2020Article
- A Knee Size-Independent Parameter for Malalignment of the Distal Patellofemoral Joint in Children.Advances in orthopedics · 2019Article
- What is the optimal valgus pre-set for intramedullary femoral alignment rods in total knee arthroplasty?Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2017Article
- Joint line level in revision total knee replacement: assessment and functional results with an average of seven years follow-up.International orthopaedics · 2016Article
- The medial and lateral epicondyle as a reliable landmark for intra-operative joint line determination in revision knee arthroplasty.Bone & joint research · 2016Article
- [The Berlin diagnostic algorithm for painful knee TKA].Der Orthopade · 2016Review
- Effect of Joint Line Elevation after Posterior-stabilized and Cruciate-retaining Total Knee Arthroplasty on Clinical Function and Kinematics.Chinese medical journal · 2015Article
- Assessing joint line positions by means of the contralateral knee: a new approach for planning knee revision surgery?Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2015Article
- Joint line restoration during revision total knee arthroplasty: an accurate and reliable method.SpringerPlus · 2015Article
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7 authors.
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Abstract
purposeRestoring the joint line (JL) improves clinical and functional outcome in total knee arthroplasty (TKA). Therefore, anatomical landmarks to approximate the JL have been published. So far, the natural deviation of the JL 90° to the mechanical tibial axis has not been considered. Thus, we designed this study to: (1) determine the natural JL of knees in healthy persons in respect to the mechanical tibial axis, (2) validate and double-check intra-operative bony landmarks already been published in respect to the natural JL and (3) find possible correlations between distances from bony landmarks to the JL and femoral and tibial width.
methodsEighty MRI scans of knees of healthy persons were examined by two independent observers. Distances from the tip of the fibular head (FH), the medial (ME) and lateral (LE) epicondyles and the adductor tubercle (AT) to the JL within the medial and lateral compartment were measured. Further, we determined the orientation of the JL in respect to the mechanical axis of the tibia. Interobserver correlations were calculated. Differences were analyzed using Student's t test. Linear regression models were calculated to analyze correlations.
resultsInterobserver correlation was excellent. Mean JL deviation was 4.2° varus. Distance between the FH, ME, LE and AT to the JL within the medial compartment was 12.2, 33.9, 33.4 and 45.4 mm, respectively. Within in the lateral compartment, distances were 15.3, 31.0, 30.6 and 42.3 mm to the JL. Strong correlation was found between femoral width and distances from the AT, ME and LE to the JL.
conclusionIn TKA, the JL is usually altered due to the classic resection technique, which does not respect the natural deviation of the JL. Estimating the natural JL by adding absolute values to bony landmarks, as proposed in the literature, is not recommended. According to our data, the JL can be best estimated by adding the calculated value: 6.40 + (width femur [mm] × 0.49) to the AT.
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