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Joint line and patellar height restoration after revision total knee arthroplasty

  • Knee Symposium
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Background

Restoration of proper joint line (JL) position and patellar height in revision total knee arthroplasty (TKA) is essential in the recovery of knee function and kinematics. We determined whether the JL position and patellar height could be restored in patients undergoing septic and aseptic revision TKA.

Materials and Methods

We retrospectively reviewed 70 patients (74 knees) who had revision TKA between September 2004 and December 2010. Forty seven knees had a two stage revision for infected TKA and 27 knees for aseptic failure. The JL position, patellar height and patellar tendon (PT) length were measured and compared between primary TKA and post revision. The clinical scores including a hospital for special surgery (HSS), Knee Society Score (KSS), Western Ontario and McMaster Universities (WOMAC) and range of motion (ROM) were compared.

Results

The overall JL increased from 17.51 mm to 18.37 mm post revision, the Insall-Salvati (IS) ratio declined from 0.98 to 0.92, and the PT length declined from 42.92 mm to 39.45 mm. 9 of the 21 patellar baja knees improved to normal patellar height. After revision, the JL in the septic group (17.02 mm) was significantly lower than the aseptic group (20.74 mm). The changes of the JL position and IS ratio in the septic group were significantly larger than the aseptic groups (P < 0.05). JL position had a positive correlation to the IS ratio and PT length post revision. The knee function scores including HSS, KSS, WOMAC scores, and ROM all improved post revision compared to pre revision (P < 0.05), and the septic group had a lower knee function compared to the aseptic group. JL position and IS ratio post revision had no correlation to the HSS, KSS, WOMAC scores, and ROM.

Conclusions

JL position can be sufficiently restored with appropriate distal femoral augment reconstruction after revision TKA, but the patellar height cannot be well improved, especially in the septic revision with obvious PT contracture. No correlation was found between the JL position and patellar height to the knee function post revision TKA.

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Authors and Affiliations

  1. Center for Joint Disease, Chonnam National University, Hwasun Hospital, 160, Ilsim-Ri, Hwasun-Eup, Hwasun-Gun, Jeonnam, 519-809, Korea

    Jong-Keun Seon & Eun-Kyoo Song

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  1. Jong-Keun Seon
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  2. Eun-Kyoo Song
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Correspondence to Jong-Keun Seon.

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Seon, JK., Song, EK. Joint line and patellar height restoration after revision total knee arthroplasty. IJOO 50, 159–165 (2016). https://doi.org/10.4103/0019-5413.177569

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  • DOI: https://doi.org/10.4103/0019-5413.177569

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