The influence of joint line position on knee stability after condylar knee arthroplasty

J. W. Martin, L. A. Whiteside

Research output: Contribution to journalArticle

141 Scopus citations


Using a special knee-testing device, ten knees obtained at autopsy were subjected to varus-valgus, anterior-posterior, and flexion -rotation analysis in the intact state and after total knee arthroplasty. The ten knees showed no significant change in stability after knee replacement when the joint line was maintained in its natural position. When the femoral component was repositioned 5 mm proximally and 5 mm anteriorly, a significant increase in laxity occurred during midflexion. When the joint line was shifted 5 mm distal and 5 mm posterior to its anatomic location, significant tightening occurred in midrange of motion. Coupled rotation of the tibia with knee flexion was decreased after surgery in all knees with no specific relationship to joint line position. Coupled rotation with varus-valgus testing, however, remained within the normal range through the first 30° of flexion only when the joint line was restored to its normal anatomic position. Stability in condylar knee arthroplasty is in part dependent on position of the joint line. Surgical techniques that rely on restoring the flexion and extension gap without regard to joint line position may result in alteration of varus-valgus or anterior-posterior displacement in midrange flexion.

Original languageEnglish
Pages (from-to)146-156
Number of pages11
JournalClinical orthopaedics and related research
Issue number259
StatePublished - Jan 1 1990
Externally publishedYes

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