J Knee Surg 2018; 31(08): 761-766
DOI: 10.1055/s-0037-1608821
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Biomechanical Implications of an Oblique Knee Joint Line

Jessica M. Hooper
1  Department of Orthopaedic Surgery, NYU Langone Medical Center's Hospital for Joint Diseases, New York, New York
,
Peter Walker
1  Department of Orthopaedic Surgery, NYU Langone Medical Center's Hospital for Joint Diseases, New York, New York
2  Department of Orthopaedic Surgery, Laboratory for Orthopaedic Implant Design, New York, New York
,
Tzu-Ting Hsu
3  Department of Mechanical Engineering, Rochester Institute of Technology, Rochester, New York
,
Anton Kurtz
1  Department of Orthopaedic Surgery, NYU Langone Medical Center's Hospital for Joint Diseases, New York, New York
,
Ryan Reynolds
4  Department of Mechanical Engineering, New York University Polytechnic School of Engineering, Brooklyn, New York
,
Daniel Hennessy
4  Department of Mechanical Engineering, New York University Polytechnic School of Engineering, Brooklyn, New York
,
Alice Chu
1  Department of Orthopaedic Surgery, NYU Langone Medical Center's Hospital for Joint Diseases, New York, New York
› Author Affiliations
Further Information

Publication History

17 January 2017

15 October 2017

Publication Date:
28 November 2017 (eFirst)

Abstract

Surgical correction of multiapical deformities of the lower limb requires careful preoperative planning. Surgeons must account for the potential creation of secondary deformity, such as knee joint line obliquity, and the risks associated with accepting these changes in limb alignment. In this study, we evaluate the effect of knee joint obliquity on tibial plateau contact pressures and knee instability. Three cadaveric knees were dissected and put through biomechanical testing to simulate loading of an oblique knee joint. We observed < 1 mm femoral displacement (proxy measure of instability) between 15 degrees of varus tilt and 10 degrees of valgus tilt, and greater increases in tibial plateau contact pressures with valgus tilt than with varus tilt. Our results suggest that, if the creation of a secondary coronal plane deformity at the knee joint cannot be avoided, up to 15 degrees of varus or 10 degrees of valgus alignment can be tolerated by an otherwise structurally normal knee.