Sensitivity of Standing Radiographs to Detect Knee Arthritis: A Systematic Review of Level I Studies

Duncan, Stephen T.; Khazzam, Michael; Burnham, Jeremy M.; Spindler, Kurt P.; Dunn, Warren R.; Wright, Rick W.

doi:10.1016/j.arthro.2014.08.023

Cited by 36 publications

(21 citation statements)

References 66 publications

(71 reference statements)

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“…[19] Joint space width (JSW) in the lateral compartment was determined in a systematic manner following the midpoint technique described by Ravaud et al[20] A digital calibrated scale was used to measure the distance in millimeters. The radiographs were graded in blinded fashion according to the K-L grading system (Supplementary Fig.…”

Section: Methodsmentioning

confidence: 99%

Histopathological assessment of primary osteoarthritic knees in large patient cohort reveal the possibility of several potential patterns of osteoarthritis initiation

Mantripragada

Piuzzi

Zachos

et al. 2017

Current Research in Translational Medicine

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Objective The two main objectives of the study include 1) Test the hypothesis that the lateral femoral condyle (LFC) in patients with primary OA and varus knees undergoing total knee arthroplasty (TKA) can be used as a model to better characterize varying histological features of human OA. 2) Correlate characteristic OA features using the established histopathological scoring systems (HHGS and OARSI) to understand potential histopathological patterns of OA initiation. Design Two osteochondral specimens (4×4×8mm) were collected from fifty patient’s LFC at the time of TKA (total 100 specimens), who presented preserved lateral knee compartment with joint space width >2mm. Three independent readers graded the sections on three different occasions using HHGS and OARSI systems. The correlation between individual parameters of the two scoring systems and their inter- and intra-reader variability, reliability and reproducibility were estimated. Results All samples in this cohort showed abnormal histopathological features. Total histopathological scores of the LFC ranged from HHGS median=4.6 (range=0 to 11), and OARSI median=5.2 (range=0 to 19.5). The four individual sub-items of HHGS scoring system (structure, cells, safraninO staining, tidemark) were weakly correlated, with the correlation between structure and cellularity being the strongest (r=0.40). Both the scoring systems had similar repeatability and reproducibility coefficients of <21%. Conclusions OA changes in the LFC are not confined to any one region, and maybe seen in different regions of cartilage, tidemark, subchondral bone, and/or the marrow space vascularity. These variations may point to the possibility of several potential patterns of initiation in OA.

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Section: Methodsmentioning

confidence: 99%

Histopathological assessment of primary osteoarthritic knees in large patient cohort reveal the possibility of several potential patterns of osteoarthritis initiation

Mantripragada

Piuzzi

Zachos

et al. 2017

Current Research in Translational Medicine

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“…[27][28][29] Wright and MARS group, correlating osteoarthritis classification with arthroscopic articular cartilage findings, concluded that "IKDC classification assessed with use of 45º postero-anterior flexion Weight-Bearing radiographs had the most favourable combination of reliability and correlation''. [30][31][32] Of course, the best way to confirm articular cartilage degeneration is observing directly using arthroscopy.…”

Section: Discussionmentioning

confidence: 99%

Macroscopic analysis of the patella cartilage during total knee replacement

Schwartsmann¹,

Spinelli²,

Silva³

et al. 2019

MOJOR

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Background: Knee osteoarthritis is diagnoses and monitored with radiography. Arthroscopy is considered the most valid method for evaluation of cartilage lesions. The best way for grading, measure and dimension is direct visualisation. Methods: Patelar cartilage lesion was analysed macroscopically during 176 total knee replacement. The grading of cartilage lesion, by direct visualisation, indentified six diferents groups. Results: Patellar articular cartilage was damaged in all 176 cases. There was no evidence of association between grade of arthrosis, gender, side or age. There is an association between tricompartmental arthrosis, varus deformity, obesity and grade of patelar arthrosis. Conclusion: All classifications systems regarding the femoropatellar cartilage lesions are unrealistic. Important subchondral bone exposure occurred in 77,2% patelar articular surface.

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“…In addition, lateral, 45-degree weight-bearing flexion postero-anterior, and patellofemoral radiographs should be obtained to assess for arthritic changes. 51, 52 Computed topography (CT) imaging with 3D reconstruction should be obtained to assess the femoral and tibial tunnel positions and size. Magnetic resonance imaging (MRI) should be carefully reviewed for associated injuries such as meniscal tears, anterolateral capsule injuries, menisco-capsular separation, and additional ligamentous injuries.…”

Section: Technical Considerations For Revision Acl Reconstruction Surmentioning

confidence: 99%

Technical Considerations in Revision Anterior Cruciate Ligament Reconstruction for Operative Techniques in Orthopaedics

Burnham

Herbst

Pauyo

et al. 2017

Operative Techniques in Orthopaedics

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As the incidence of anterior cruciate ligament (ACL) reconstruction continues to increase, the rate of revision surgery continues to climb. Revision surgery has inherent challenges that must be addressed in order to achieve successful results. The cause of the primary ACL reconstruction failure should be determined, and careful preoperative planning should be performed to address the cause(s) of failure. Each patient undergoing revision surgery should undergo a thorough history and physical examination, receive full length alignment radiographs, lateral radiographs, 45-degree flexion weight-bearing postero-anterior radiographs, and patellofemoral radiographs. 3-dimensional computed topography (CT) scan should be performed to assess tunnel position and widening. Magnetic resonance imaging (MRI) should be used to assess for intra-articular soft tissue pathology. Meniscal tears, meniscal deficiency, anterolateral capsule injuries, bony morphology, age, activity level, connective tissue diseases, infection, graft choice, and tunnel position can all impact the success of ACL reconstruction surgery. Meniscal lesions should be repaired, and in cases of persistent rotatory instability, extra-articular procedures may be indicated. Furthermore, osteotomies may be needed to correct malalignment or excess posterior tibial slope. Depending on the placement and condition of the original femoral and tibial tunnels, revision surgery may be performed in a single procedure or in a staged manner. In most cases, the surgery can be performed in one procedure. Regardless, the surgeon must communicate with the patient openly regarding the implications of revision ACL surgery and the treatment plan should be developed in a shared fashion between the surgeon and the patient.

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Sensitivity of Standing Radiographs to Detect Knee Arthritis: A Systematic Review of Level I Studies

Cited by 36 publications

References 66 publications

Histopathological assessment of primary osteoarthritic knees in large patient cohort reveal the possibility of several potential patterns of osteoarthritis initiation

Histopathological assessment of primary osteoarthritic knees in large patient cohort reveal the possibility of several potential patterns of osteoarthritis initiation

Macroscopic analysis of the patella cartilage during total knee replacement

Technical Considerations in Revision Anterior Cruciate Ligament Reconstruction for Operative Techniques in Orthopaedics

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