Validation of joint space narrowing on plain radiographs and its relevance to partial knee arthroplasty

peer-reviewed
Erstveröffentlichung
2021-03-09Authors
Khury, Farouk
Fuchs, Michael
Malik, Hassan Awan
Leiprecht, Janina
Reichel, Heiko
Wissenschaftlicher Artikel
Published in
Bone & Joint Research ; 10 (2021), 3. - S. 173-187. - eISSN 2046-3758
Link to original publication
https://dx.doi.org/10.1302/2046-3758.103.BJR-2020-0216.R1Institutions
Rehabilitationskrankenhaus UlmExternal cooperations
Rambam Health Care CampusDocument version
published version (publisher's PDF)Abstract
Aims
To explore the clinical relevance of joint space width (JSW) narrowing on standardized-flexion (SF) radiographs in the assessment of cartilage degeneration in specific subregions seen on MRI sequences in knee osteoarthritis (OA) with neutral, valgus, and varus alignments, and potential planning of partial knee arthroplasty.
Methods
We retrospectively reviewed 639 subjects, aged 45 to 79 years, in the Osteoarthritis Initiative (OAI) study, who had symptomatic knees with Kellgren and Lawrence grade 2 to 4. Knees were categorized as neutral, valgus, and varus knees by measuring hip-knee-angles on hip-knee-ankle radiographs. Femorotibial JSW was measured on posteroanterior SF radiographs using a special software. The femorotibial compartment was divided into 16 subregions, and MR-tomographic measurements of cartilage volume, thickness, and subchondral bone area were documented. Linear regression with adjustment for age, sex, body mass index, and Kellgren and Lawrence grade was used.
Results
We studied 345 neutral, 87 valgus, and 207 varus knees. Radiological JSW narrowing was significantly (p < 0.01) associated with cartilage volume and thickness in medial femorotibial compartment in neutral (r = 0.78, odds ratio (OR) 2.33) and varus knees (r = 0.86, OR 1.92), and in lateral tibial subregions in valgus knees (r = 0.87, OR 3.71). A significant negative correlation was found between JSW narrowing and area of subchondral bone in external lateral tibial subregion in valgus knees (r = −0.65, p < 0.01) and in external medial tibial subregion in varus knees (r = −0.77, p < 0.01). No statistically significant correlation was found in anterior and posterior subregions.
Conclusion
SF radiographs can be potentially used for initial detection of cartilage degeneration as assessed by MRI in medial and lateral but not in anterior or posterior subregions.
Cite this article: Bone Joint Res 2021;10(3):173–187.
Keywords: Osteoarthritis cartilage, Joint space narrowing, Partial knee arthroplasty, Osteoarthritis radiography, Cartilage radiography
Publication funding
Open-Access-Förderung durch die Medizinische Fakultät der Universität Ulm
Subject headings
[GND]: Osteoarthritis | Knorpel | Kniegelenkprothese[MeSH]: Osteoarthritis | Osteoarthritis; Diagnostic imaging | Cartilage | Arthroplasty, Replacement, Knee
[Free subject headings]: Joint space narrowing | Partial knee arthroplasty | Osteoarthritis radiography | Cartilage radiography
[DDC subject group]: DDC 610 / Medicine & health
Metadata
Show full item recordDOI & citation
Please use this identifier to cite or link to this item: http://dx.doi.org/10.18725/OPARU-38062
Khury, Farouk et al. (2021): Validation of joint space narrowing on plain radiographs and its relevance to partial knee arthroplasty. Open Access Repositorium der Universität Ulm und Technischen Hochschule Ulm. http://dx.doi.org/10.18725/OPARU-38062
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