SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019
The negative effect of joint line elevation after total knee arthroplasty on outcome.
Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
56 citing papers in PubMed.
- Does the gap balance technique really elevate the joint line in total knee arthroplasty? A single-center, randomized study.Joint diseases and related surgery · 2025Trial
- Differences in joint line level and posterior condylar offset during total knee replacement with use of gap-balancing and measured resection techniques-matched cohort study.BMC musculoskeletal disorders · 2023Trial
- Robotic-assisted TKA leads to a better prosthesis alignment and a better joint line restoration as compared to conventional TKA: a prospective randomized controlled trial.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Trial
- Similar postoperative outcomes after total knee arthroplasty with measured resection and gap balancing techniques using a contemporary knee system: a randomized controlled trial.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2021Trial
- Impact of Joint Line Displacement on Function and Quality of Life After Primary Total Knee Arthroplasty.Journal of clinical medicine · 2026Article
- Impact of flexion contracture severity on early outcomes of computer-navigated total knee arthroplasty: a retrospective cohort study.Journal of orthopaedic surgery and research · 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
- Posterior femoral condylar morphology following mechanical vs. kinematic alignment using a medial-pivot implant designed for mechanical alignment: A CT-based comparative study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- ICF rehabilitation set responsiveness after total knee arthroplasty: a retrospective study.Frontiers in rehabilitation sciences · 2026Article
- Does patellar height influence functional outcomes after reconstruction in distal femur tumours?Journal of clinical orthopaedics and trauma · 2025Article
- Joint line elevation after TKA is higher in patients with metaphyseal deformity: a prospective study.Archives of orthopaedic and trauma surgery · 2025Article
- Adductor tubercle as a reliable landmark for knee joint line determination: a comparative radiological study.Archives of orthopaedic and trauma surgery · 2025Article
- miR-708-5p Attenuates Osteoarthritis Progression via Multi-Target Modulation of the NOX4/NF-κB Axis and Cartilage Homeostasis.Cartilage · 2025Article
- Pre-operative and Intra-operative Factors Affecting Post-operative Range of Motion in Total Knee Arthroplasty: A Prospective Clinical and Radiological Study.Indian journal of orthopaedics · 2025Article
- Predictors of post-operative decline in knee flexion after cruciate-retaining total knee arthroplasty.Journal of experimental orthopaedics · 2025Article
- Similar kinematic patterns in posterior-stabilized and condylar constrained knee prostheses in revision knee arthroplasty: a prospective cohort study.Journal of orthopaedics · 2025Article
- Lateralized position of femoral and tibial components during posterior-stabilized total knee arthroplasty leads to better functional outcomes.Knee surgery & related research · 2025Article
- 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
- Robotic-assisted total knee arthroplasty provides better joint line and posterior condylar offset restoration than conventional total knee arthroplasty: a retrospective study of radiological outcomes.Journal of robotic surgery · 2025Article
- Comparison between ligament balancing and measured resection in robot-assisted total knee arthroplasty: a 2-year follow up cohort study.BMC musculoskeletal disorders · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTotal knee arthroplasty (TKA) is widely used as a treatment for knee osteoarthritis. However, still up to 20% of the patients are dissatisfied. Joint line elevation after TKA might be a contributing factor as it alters knee kinematics. The aim of this study was to investigate the effect of joint line elevation on outcome.
methodsA systematic review of the literature was performed to select studies that reported on joint line alterations after primary or revision TKA and outcome. Studies with comparable outcome parameters were included in a correlation analysis.
resultsIn total, 396 studies were identified, of which 27 met the inclusion criteria. 8 studies could be included in the correlation analysis. Mean joint line elevation after primary TKA was 3.0 mm and after revision TKA this was 3.6 mm. A statistically significant negative correlation was found between joint line elevation and the postoperative Knee Society Score (KSS) function score (ρ = - 0.496, p < 0.001). In a pooled analysis, the maintained joint line revision TKA group had statistically significant better postoperative KSS total scores compared to an elevated joint line group (p < 0.001).
conclusionIn this systematic review, a negative correlation between joint line elevation and outcome was found. Furthermore, revision TKAs with a maintained joint line have statistically significant better postoperative KSS scores compared to an elevated joint line group. To achieve optimal outcome after TKA, restoration of the joint line is one of the parameters that should be pursued and introduced elevation should not exceed 4 mm. LEVEL OF EVIDENCE: IV.
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