The clinical significance of joint line in primary total knee arthroplasty and revision total knee arthroplasty

Abstract

The number of patients undergoing total knee arthroplasty (TKA) has increased with aging. Further, the number of revision TKA has also increased. The position of joint line is closely related to the function of knee joint. Thus, the height of joint line has gradually attracted the attention of surgeons. The position of joint line affects knee function and patient satisfaction after TKA by affecting the function of patellofemoral joint, wear of polyethylene, range of motion and joint stability. However, there are still some disputes about the measurement of the joint line, the position of joint line and the method in TKA. Especially in revision TKA, it is difficult to determine the position of joint line because of the destruction of bone anatomical marks by the primary TKA. Developing a reliable anatomic marker to localize joint line is crucial for primary and revision TKA. In the present review, the accuracy, advantages and disadvantages of joint line measurement, patellofemoral joint function, wear of polyethylene liner, joint mobility, joint stability and control of joint line are discussed to analyze the effects of joint line elevation and reduction on knee joint function in primary and revision TKA.