Study finds, Tibial joint line orientation has no effect on
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Joint line orientation (JLO) plays an important role in total knee arthroplasty (TKA). The purpose of this study was to examine JLO impact as measured by the forgotten joint score (FJS-12). The hypothesis was that restoring the joint line (JL) parallel to the floor would influence joint awareness favorably.

All computer-navigated primary TKAs using a cemented, cruciate-retaining (CR) design implanted were reviewed in this retrospective single-center analysis. Primary endpoints were: clinical [range of motion (ROM)], and patient-reported (FJS-12) and radiographical outcomes [tibia joint line angle (TJLA), hip knee axis (HKA), mechanical medial proximal tibia angle (mMPTA) as well as mechanical lateral distal femoral angle (mLDFA)].

--76 patients were included. Postoperative ROM averaged 118.7±9.6°.

--The mean FJS-12 improved from 16.4±15.3 (preoperatively) to 89.4±16.9.

--Clinical outcomes and PROs did not correlate with JLO.

--Cluster analysis using six measures revealed that a medially opened TJLA was associated with significantly better postoperative FJS-12.

Tibial JLO, in particular, was found to have no effect on PROs. Consideration of the JLO in the coronal plane alone is probably of dubious clinical use. The alignment of the lower limbs should be evaluated in all three planes and connected with the clinical outcome.