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Change in collateral ligament length and tibiofemoral movement following joint line variation in TKA

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The primary intent of total knee arthroplasty is the restoration of normal knee kinematics, with ligamentous constraint being a key influential factor. Displacement of the joint line may lead to alterations in ligament attachment sites relative to knee flexion axis and variance of ligamentous constraints on tibiofemoral movement. This study aimed to investigate collaterals strains and tibiofemoral kinematics with different joint line levels.

Methods

A previously validated knee model was employed to analyse the change in length of the collateral ligaments and tibiofemoral motion during knee flexion. The models shifted the joint line by 3 and 5 mm both proximally and distally from the anatomical level. The data were captured from full extension to flexion 135°.

Results

The elevated joint line revealed a relative increase in distance between ligament attachments for both collateral ligaments in comparison with the anatomical model. Also, tibiofemoral movement decreased with an elevation in the joint line. Conversely, lowering the joint line led to a significant decrease in distance between ligament attachments, but greater tibiofemoral motion.

Conclusion

Elevation of the joint line would strengthen the capacity of collateral ligaments for knee motion constraint, whereas a distally shifted joint line might have the advantage of improving tibiofemoral movement by slackening the collaterals. It implies that surgeons can appropriately change the joint line position in accordance with patient’s requirement or collateral tensions. A lowered joint line level may improve knee kinematics, whereas joint line elevation could be useful to maintain knee stability.

Level of evidence

V.

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Acknowledgments

We acknowledge the financial support of the Administrative Bureau of Southern Taiwan Science Park (BY-03-04-17-98).

Conflict of interest

No conflicts of interest on this manuscript.

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Authors and Affiliations

  1. Technology Translation Center for Medical Device, Chung Yuan Christian University, Chungli City, Taiwan

    Kun-Jhih Lin & Hung-Wen Wei

  2. Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan

    Hung-Wen Wei

  3. Biomechanics Research Laboratory, Department of Biomedical Research, Mackay Memorial Hospital, New Taipei City, Taiwan

    Chang-Hung Huang

  4. United Orthopedic Corporation, Taipei, Taiwan

    Yu-Liang Liu

  5. Orthopaedic Device Research Center, National Yang-Ming University, Taipei, Taiwan

    Wen-Chuan Chen

  6. Orthopaedic Biomechanics Laboratory, Institute of Biomedical Engineering, National Yang-Ming University, No. 155, Sec. 2, Li-Nung St., Shih-Pai, Taipei, 11221, Taiwan

    Colin Joseph McClean & Cheng-Kung Cheng

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  1. Kun-Jhih Lin
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  2. Hung-Wen Wei
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  3. Chang-Hung Huang
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  4. Yu-Liang Liu
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  7. Cheng-Kung Cheng
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Corresponding author

Correspondence to Cheng-Kung Cheng.

Additional information

Hung-Wen Wei and Chang-Hung Huang have equally contributed to this work.

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Lin, KJ., Wei, HW., Huang, CH. et al. Change in collateral ligament length and tibiofemoral movement following joint line variation in TKA. Knee Surg Sports Traumatol Arthrosc 24, 2498–2505 (2016). https://doi.org/10.1007/s00167-014-3400-z

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  • DOI: https://doi.org/10.1007/s00167-014-3400-z

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