Joint Line Reconstruction in Revision Knee Arthroplasty - Reliability Testing of Radiologic Anatomic Landmarks versus a Novel Defined Landmark

Kai H, Lisa W, Felix K, Peer E and Johannes O

Department of Orthopaedic, Trauma and Plastic Surgery, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany

^*Correspondance to: Kai Hoffeld 

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Abstract:

Objectives: Bony landmarks are necessary for intraoperative orientation. Such bony landmarks have been studied before, but no common sense was found about which landmark should be used. Hence, we investigate a novel bony landmark located on the posterior edge of the tibia, which is not changed during primary knee arthroplasty, with regard to its reliability and validity. Methods: In this retrospective study we analyzed conventional radiographs of a total of 100 patients who underwent a primary knee arthroplasty. Measurements were taken by three independent examiners. Marking of the knee joint gap was performed on pre- and post-operative radiographs, thus various bony landmarks have been investigated. Results: The difference between the mean value determined preoperatively and postoperatively is 0.66 mm to 2.41 mm, depending on the point used. For the new measurement point, a distance of 44.8 mm (SD 8.5) is measured preoperatively and 46.9 mm (SD 8.7) postoperatively. Both pre- and post-operatively determined intra- and inter-class coefficients have values mostly >0.85, which corresponds to an excellent agreement. Preoperatively, the new measurement point has an intraclass coefficient of 0.94, and postoperatively 0.92. For the interclass coefficient, the preoperative value is 0.97 and the postoperative value is 0.85. Conclusion: The point in the area of the proximal tibia investigated in this study has a very high reliability and certainly represents another radiological - anatomical landmark for the detection of the joint line in relation to endoprosthetic revision procedures. It represents a safe alternative, especially when the usual bony landmarks are altered or even missing due to the previous, sometimes multiple operations.

Keywords:

Knee arthroplasty; Revision arthroplasty; Joint line; Anatomic landmark

Cite the Article:

Kai H, Lisa W, Felix K, Peer E, Johannes O. Joint Line Reconstruction in Revision Knee Arthroplasty - Reliability Testing of Radiologic Anatomic Landmarks versus a Novel Defined Landmark. World J Surg Surgical Res. 2023; 6: 1510..