Joint line restoration during revision knee replacement (literature review)

Total knee arthroplasty is becoming the most effective and common method of treatment for terminal stages of osteoarthrosis and other degenerative diseases of the knee joint. One of the main points in arthroplasty of the knee joint is the restoration of the normal level of the joint line and posterior offset of the femur. For clinical use, a number of methods have been proposed for determining the desired level of the articular line, each of which has its advantages and disadvantages. This article provides an overview of the above methods, analyzes the mechanism and consequences of changes in the level of the articular line. Based on the research data obtained in the analyzed articles, practical recommendations have been formed for the surgeon, which consist of the points required special attention while performing both primary and especially revision knee replacement.In fairness, I want to note that up to date, the optimal method for determining the normal level of the joint line in the primary or revision of knee joint replacement has not been established. Therefore, in order to minimize possible errors during preoperative planning, it is advisable to use the mathematical formulas proposed in the article, and performing the operation, use all available anatomical landmarks to determine the normal level of the joint line, trying to restore it with an accuracy of ± 4 mm from the native level.