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Joint line position restoration during revision total knee replacement
1The Knee Service, Hopital for Special Surgery, New York, NY 10021, USA. laskinr@aol.com
Clinical Orthopaedics and Related Research
|November 20, 2002
Summary
Revision knee replacement often involves proximal prosthetic joint line malposition. Restoring the joint line using distal femoral augments and specific anatomical landmarks is crucial for successful revision surgery.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Instability is a common indication for knee replacement revision surgery.
- Proximal malpositioning of the prosthetic joint line occurs in over half of revision cases.
Purpose of the Study:
- To review revision knee replacement operations for instability.
- To identify common causes of revision and methods for joint line restoration.
Main Methods:
- Review of 45 revision knee replacement surgeries in 44 patients indicated for instability.
- Utilized fibular styloid and medial epicondylar points to guide joint line positioning.
- Employed distal femoral augments and balanced flexion/extension spaces for correction.
Main Results:
- Over 50% of patients presented with a proximally malpositioned prosthetic joint line.
- Successful joint line restoration was achieved during revision surgery.
- The Insall-Salvati ratio was found to be inapplicable due to patellar tendon issues.
Conclusions:
- Proximal joint line malposition is a frequent challenge in knee replacement revisions for instability.
- Distal femoral augments and anatomical landmarks provide effective methods for joint line restoration.
- Alternative methods to the Insall-Salvati ratio are necessary for joint line assessment in revision cases.