Department of Orthopaedic Surgery, Centre of Musculoskeletal Research, University of Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany,
Arch Orthop Trauma Surg. 2014 Apr;134(4):537-41. doi: 10.1007/s00402-014-1953-4. Epub 2014 Feb 9.
Restoring the joint line (JL) in primary as well as revision total knee arthroplasty (TKA) influences clinical results as well as long-term survival rates. Whereas studies agree about the negative effect of JL alteration, the reference system of choice is unclear. The purpose of the present study was to evaluate the effect of JL allocation comparing a ratio to a distance method on clinical outcome following revision TKA.
After a miminum follow-up of 2 years JL reconstruction was evaluated in 69 consecutive patients after revision TKA. Clinical results were obtained using the Knee Society Score (KSS). We used the Figgie distance method in comparison to the epicondylar ratio method.
The mean postoperative KSS significantly improved in all 69 revision TKAs compared to the preoperative value. Patients with a positive JL reconstruction in reference to the epicondylar ratio showed significantly better KSS results compared to knees without restoration of the JL. The degree of JL reconstruction depending on the distance method showed no effect on postoperative KSS results.
We recommend the epicondylar ratio to calculate the physiological JL rather than JL allocation by a distance.
在初次全膝关节置换术（TKA）和翻修 TKA 中，恢复关节线（JL）会影响临床结果和长期生存率。虽然研究都认为 JL 改变会产生负面影响，但目前还不清楚哪种参考系统是最佳选择。本研究旨在评估 JL 分配（比值法与距离法）对翻修 TKA 后临床结果的影响。
在至少 2 年的随访后，对 69 例连续接受翻修 TKA 的患者进行了 JL 重建评估。使用膝关节协会评分（KSS）评估临床结果。我们比较了 Figgie 距离法和髁上比值法。
与术前相比，所有 69 例翻修 TKA 术后 KSS 均值显著提高。与未重建 JL 的膝关节相比，在髁上比值参考中 JL 重建为阳性的患者的 KSS 结果明显更好。根据距离法重建 JL 的程度对术后 KSS 结果没有影响。
我们建议使用髁上比值来计算生理 JL，而不是使用距离来分配 JL。
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