Joint line reestablishment in revision total knee arthroplasty

In this study, the traditional "Anatomical Landmark-Distance Method (AL-DM)" in the formation of joint line (JL) was compared with "Adductor Tubercle-Ratios method" (AT-RM), and the effect of reestablishment of JL on clinical and functional outcomes were evaluated. 16 revision total knee arthroplasties (rTKAs) were performed by using "AT-RM" (group 1) and 16 rTKA by using "AL-DM" (group 2) in our clinic between 2015 and 2018. The data were prospectively collected and a total of 32 knees of 31 patients were analyzed. At the final follow-up, knee functions were evaluated by using Knee Society Score (KSS) knee and function, Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, Short Form-36 (SF-36) questionnaires and physical examinations. Postoperative flexion arc was higher in Group 1. KSS knee and function scores were better in group 1. In group1, JL was reestablished successfully in all revision rTKAs in terms of ATJL and the tibial tubercle TT-JL ratios. The improvement in KSS knee and function scores and WOMAC scores were also better in group 1. Measurements showed that the improvement in KSS scores increased as AT-JL and TT-JL distances approached the calculated values. "AT-RM" was shown to be superior to the traditional distance method in terms of JL reestablishment. Functional results and patient satisfaction increased when JL was reestablished.