ArticleJournal of clinical orthopaedics and trauma2025
Estimation of adductor ratio in the Indian population: Is it a reliable indicator for recreating joint line of the knee?
Article in Journal of clinical orthopaedics and trauma, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Accurate restoration of the joint line is critical in revision total knee arthroplasty (r-TKA) to ensure proper ligament tension and optimize functional outcomes. Objective: To determine the adductor ratio in the Indian population and assess its reliability for restoring the joint line in primary total knee arthroplasty (TKA). Methods: The study consisted of two parts. In the first part, 93 young, non-arthritic individuals were evaluated radiologically to estimate the adductor ratio. In the second part, 47 patients with grade IV osteoarthritis undergoing primary TKA were included. Pre-operative radiographic and intraoperative calliper measurements of the adductor tubercle to joint line distance (ATJL) and femoral width (FW) were taken. Pearson correlation was estimated between FW and ATJL, and Bland-Altman analysis was used to assess the agreement between pre-operative and intra-operative measurements. The error in using a standard adductor ratio was estimated. Results: The mean adductor ratio in the non-arthritic population was 0.542, with a strong correlation between ATJL and FW (r = 0.81, p < 0.001). In the second part, the mean adductor ratio was consistent pre-operatively (0.53) and intra-operatively (0.54), with a bias of 0.001 and 95 % limits of agreement from -0.062 to 0.065. The estimated ATJL was within 5 mm of the actual measurement in 95 % of cases. Conclusion: The adductor ratio of 0.54 is a reliable indicator for joint line restoration in the Indian population. Documentation of ATJL and FW during primary TKA is recommended for enhancing accuracy in joint line reconstruction in revision scenarios.
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