title: An accurate and reproducible method for locating the joint line during a revision total knee arthroplasty.
abstract: Studies have shown that the position of the joint line has a direct effect on postoperative results, including range of motion, functional knee scores, and midflexion stability. Four anatomic landmarks were investigated as references for locating the joint line during a revision knee surgery--the medial femoral epicondyle, the fibular head, the tibial tubercle, and the inferior pole of the patella. Measurements from 6 cadaver knees identified the distance of each landmark to the joint line. These distances were used to design instruments to aid in the intraoperative positioning of the joint line. The instruments were validated on 94 primary total knees. The instrument referencing the medial epicondyle had 99% and 93% accuracy for locating the natural position of the joint line within 5 and 3 mm, respectively.
authors.affiliation: New England Baptist Hospital, Boston, Massachusetts, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Mason
authors.forename: Amy
authors.initials: A
authors.lastname: Belisle
authors.forename: Peter
authors.initials: P
authors.lastname: Bonutti
authors.forename: Frank R
authors.initials: FR
authors.lastname: Kolisek
authors.forename: Arthur
authors.initials: A
authors.lastname: Malkani
authors.forename: Michael
authors.initials: M
authors.lastname: Masini
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002102:Cadaver; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000033:anatomy & histology / Q000503:physiopathology; D008297:Male; D016059:Range of Motion, Articular; D012086:Reoperation