ArticleCureus2026
Correlation Between the Insall-Salvati Ratio and Functional Outcomes After Total Knee Arthroplasty.
Article in Cureus, 2026. 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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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.
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Authors and funding
5 authors.
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Abstract
Background Total knee arthroplasty (TKA) is a highly successful and cost-effective orthopedic procedure. This study aimed to assess the correlation between the Insall-Salvati ratio (ISR), a reliable measure of patellar height, and TKA outcomes. Methodology This prospective observational study was conducted at a tertiary care hospital in India for one year. Consecutive patients undergoing primary TKA for degenerative knee conditions were included. A total of 200 knees were analyzed. Patellar height was assessed using the ISR on standardized lateral knee radiographs obtained at approximately 30° of flexion, both preoperatively and postoperatively. Clinical outcomes were assessed using range of motion, pain scores, Knee Society Scores (KSS), and stair-climbing ability. Statistical analysis was performed to evaluate the correlation between ISR changes and postoperative functional outcomes. Results The study evaluated 200 TKAs in 122 males and 78 females with a mean age of 67.8 years. Postoperatively, 17.5% of knees showed patella baja, 79% had normal ISR, and 3.5% exhibited patella alta. Among knees initially classified as normal or patella alta, 10.67% developed postoperative patella baja. Females were twice as likely as males to develop new-onset patella infera, with a higher incidence (12.8% vs. 8.19%). No significant difference in ISR reduction or clinical outcomes was observed between posterior cruciate substituting and retaining implants. However, reduced ISR correlated with poorer stair-climbing and functional scores, while KSS, pain, and flexion remained unaffected. Patients whose preoperative patella baja normalized postoperatively showed functional improvement in stair-climbing. Conclusions TKA led to a reduction in patellar tendon length, reflected by a decreased ISR, in approximately half of the patients. This reduction was associated with significantly lower postoperative stair-climbing and function scores, while KSS, pain levels, and range of motion remained unaffected. Patella infera was twice as prevalent in female patients compared to males.
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