The Imperial Joint Line Congruency Measurement is a valuable tool in total knee arthroplasty
Author(s)
Popat, Ravi
Dhillon, Kieran
Mahapatra, Piyush
Khan, Hasaan
Nathwani, Dinesh
Type
Journal Article
Abstract
BACKGROUND: Preservation of joint line height is an important factor in post-operative function after Total Knee Arthroplasty (TKA). This is the first study investigating the reliability of the novel Imperial Joint Line Congruency Measurement (IJLCM) technique for the assessment of joint line height using plain radiographs. METHODS: The reliability of two techniques used to measure joint line height on pre-operative and post-operative plain radiographs is presented. 120 patients that underwent TKA from 6 different international centres were included. Measurements were performed using each technique by two senior orthopaedic surgeons at two different timepoints (test-retest). Two undergraduate medical students performed joint line measurements using the most reproducible of the two techniques on 40 pre-operative and post-operative images to establish the reliability of the measurement technique. RESULTS: The IJLCM demonstrated an average absolute difference of 1.83mm (CI 1.56-2.10mm) and excellent inter and intra-rater reliability between senior orthopaedic surgeons (>0.92 (CI 0.88-0.94) when measuring joint line height on plain radiographs. Overall Crohnbach's alpha over 0.92 confirmed internal consistency. Measurements performed using the control technique as previously described by Figgie et al. had an average absolute difference of 5.75mm (5.17-6.32mm). Comparison of measurements by senior orthopaedic surgeons and medical students using the IJLCM technique with ANOVA and student's t-test demonstrated acceptable agreement and inter-rater reliability of >0.92 (0.87-0.95). CONCLUSION: This study shows excellent accuracy, precision, and reliability of the novel IJLCM technique. Furthermore, excellent agreement between senior orthopaedic surgeons and medical students when using the IJLCM could be shown. The IJLCM technique is reliable for joint line assessment.
Date Issued
2021-09-10
Date Acceptance
2021-08-30
Citation
PLoS One, 2021, 16 (9), pp.e0257325-e0257325
ISSN
1932-6203
Publisher
Public Library of Science (PLoS)
Start Page
e0257325
End Page
e0257325
Journal / Book Title
PLoS One
Volume
16
Issue
9
Copyright Statement
© 2021 Popat et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/34506586
PII: PONE-D-21-04260
Subjects
General Science & Technology
Publication Status
Published
Coverage Spatial
United States
Article Number
ARTN e0257325