The reliability of adductor tubercle as an anatomical landmark for joint line restoration in revision knee arthroplasty: a systematic review

Joint line (JL) restoration is one of the major challenges in revision total knee arthroplasty (rTKA). There debate regarding most reliable methodology for assessment JL level during surgery. Among strategies, use adductor tubercle (AT) as an anatomical landmark has been proposed. The purpose this paper to systematically review available literature understand reliability AT ratio identify JL, and advantages drawbacks its application. A research was performed on PubMed, Embase, Cochrane Google Scholar databases based following inclusion criteria articles' selection: (I) clinical reports any evidence, (II) written English language, (III) published from 2010 2020, (IV) dealing with a restore TKA. All relevant data were extracted by two independent investigators, discrepancies resolved discussion consensus. 13 studies included: nine radiographic evaluations, 3 1 ex-vivo study. Radiographic highlighted that easy identify, high intra inter-observer agreement, irrespective gender, age size patient. comparison other bony landmarks revealed superior favor AT. Also surgical procedures, can be safely located some confirmed helps surgeon re-establishing correct achieve ligament balancing even complex cases. easily detectable landmark, valid tool determine help surgeons simultaneously r-TKA.