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- Title
Joint line reconstruction in medial unicompartmental knee arthroplasty: development and validation of a measurement method.
- Authors
Weber, Patrick; Schröder, Christian; Laubender, Rüdiger; Baur-Melnyk, Andrea; Schulze Pellengahr, Christoph; Jansson, Volkmar; Müller, Peter
- Abstract
Purpose: Preservation of the joint line in total knee arthroplasty (TKA) has shown to be an important factor for the long-term outcome, especially in revision TKA. For unicompartmental knee arthroplasty (UKA), the role of the joint line has neither been investigated nor is it consciously respected during implantation. Thus, the aim was to establish and validate a standardised measurement method to determine the joint line in UKA. Methods: As there is no established method to evaluate changes in the joint line radiologically, we introduced two methods and correlated them. The methods were first validated in a cadaver model by a controlled rotational study. Then, the joint line of 29 patients with an UKA (Oxford, Biomet, Bridgend, UK) was determined on pre- and post-operative radiographs. Both methods were tested by intra- and inter-rater reliability. Results: Both methods showed a good intra- and inter-rater reliability. Furthermore, there was only little bias in agreement between both methods and raters. Measurements of the 29 UKA patients revealed that the joint line was more distally by a mean of 4.4 ± 1.2 mm after surgery. Conclusions: The study provides for the first time a reliable and standardised measurement tool to determine the changes in the joint line after implantation of an UKA. The instrument should be used in further studies to evaluate the impact of the joint line on the long-term outcome, the load in the two non-replaced knee compartments and on the ligaments. Level of evidence: Diagnostic study without a universally applied 'gold' standard, Level III.
- Subjects
TOTAL knee replacement; KNEE radiography; MEDICAL standards; LIGAMENT physiology; DIAGNOSTIC imaging; HEALTH outcome assessment
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2013, Vol 21, Issue 11, p2468
- ISSN
0942-2056
- Publication type
Article
- DOI
10.1007/s00167-013-2617-6