scholarly journals Osteotomies for lateral compartment knee osteoarthritis

2021 ◽  
pp. 101726
Author(s):  
Om Lahoti ◽  
Mohit Bansal
Keyword(s):  
Knee Osteoarthritis ◽  
Lateral Compartment

scholarly journals Risk factor heterogeneity for medial and lateral compartment knee osteoarthritis: analysis of two prospective cohorts

2019 ◽  
Vol 27 (4) ◽  
pp. 603-610 ◽  
Author(s):  
J. Wei ◽  
D. Gross ◽  
N.E. Lane ◽  
N. Lu ◽  
M. Wang ◽  
...  
Keyword(s):  
Risk Factor ◽  
Knee Osteoarthritis ◽  
Lateral Compartment ◽  
Prospective Cohorts

Correlations between radiological classification systems and confirmed cartilage loss in severe knee osteoarthritis

2020 ◽  
Vol 102-B (3) ◽  
pp. 301-309 ◽  
Author(s):  
Oisin J. F. Keenan ◽  
George Holland ◽  
Julian F. Maempel ◽  
John F. Keating ◽  
Chloe E. H. Scott
Keyword(s):  
Knee Osteoarthritis ◽  
Correlation Coefficient ◽  
Interobserver Reliability ◽  
Severe Disease ◽  
Intraclass Correlation ◽  
Lateral Compartment ◽  
Classification Systems ◽  
Medial Compartment ◽  
Cartilage Loss ◽  
Radiological Classification

Aims Although knee osteoarthritis (OA) is diagnosed and monitored radiologically, actual full-thickness cartilage loss (FTCL) has rarely been correlated with radiological classification. This study aims to analyze which classification system correlates best with FTCL and to assess their reliability. Methods A prospective study of 300 consecutive patients undergoing unilateral total knee arthroplasty (TKA) for OA (mean age 69 years (44 to 91; standard deviation (SD) 9.5), 178 (59%) female). Two blinded examiners independently graded preoperative radiographs using five common systems: Kellgren-Lawrence (KL); International Knee Documentation Committee (IKDC); Fairbank; Brandt; and Ahlbäck. Interobserver agreement was assessed using the intraclass correlation coefficient (ICC). Intraoperatively, anterior cruciate ligament (ACL) status and the presence of FTCL in 16 regions of interest were recorded. Radiological classification and FTCL were correlated using the Spearman correlation coefficient. Results Knees had a mean of 6.8 regions of FTCL (SD 3.1), most common medially. The commonest patterns of FTCL were medial ± patellofemoral (143/300, 48%) and tricompartmental (89/300, 30%). ACL status was associated with pattern of FTCL (p = 0.023). All radiological classification systems demonstrated moderate ICC, but this was highest for the IKDC: whole knee 0.68 (95% confidence interval (CI) 0.60 to 0.74); medial compartment 0.84 (95% CI 0.80 to 0.87); and lateral compartment 0.79 (95% CI 0.73 to 0.83). Correlation with actual FTCL was strongest for Ahlbäck (Spearman rho 0.27 to 0.39) and KL (0.30 to 0.33) systems, although all systems demonstrated medium correlation. The Ahlbäck score was the most discriminating in severe knee OA. Osteophyte presence in the medial compartment had high positive predictive value (PPV) for FTCL, but not in the lateral compartment. Conclusion The Ahlbäck and KL systems had the highest correlation with confirmed cartilage loss at TKA. However, the IKDC system displayed the best interobserver reliability, with favourable correlation with FTCL in medial and lateral compartments, although it was less discriminating in more severe disease. Cite this article: Bone Joint J 2020;102-B(3):301–309

scholarly journals Radiographic vs. MRI vs. arthroscopic assessment and grading of knee osteoarthritis - are we using appropriate imaging?

2022 ◽  
Vol 9 (1) ◽  
Author(s):  
Samuel Newman ◽  
Huzefah Ahmed ◽  
Nader Rehmatullah
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Imaging Techniques ◽  
Lateral Compartment ◽  
Medial Compartment ◽  
Actual Condition ◽  
Tertiary Centre ◽  
Arthroscopic Findings ◽  
Mri Scans ◽  
Outerbridge Grade

Abstract Purpose Radiographs and MRI scans are commonly used imaging techniques in the assessment of knee osteoarthritis. However, it currently remains uncertain how good a representation of the actual condition of the knee joint these investigations provide. By comparing them against arthroscopic findings the aim of our study was to conclude how accurate these imaging techniques are at grading knee osteoarthritis. Methods This was a retrospective study looking at knee arthroscopies performed at a tertiary centre over a 5 year period. The Outerbridge grade given at arthroscopy was correlated with pre-operative radiograph and MRI scores, so as to assess the reliability of these imaging techniques at predicting the actual severity of knee osteoarthritis seen. Results Kellgren-Lawrence (KL) grading of radiographs was moderately correlated with Outerbridge grades from arthroscopy for the medial compartment of the knee (Spearman’s rho (SR) 0.483, p < 0.001), with a milder correlation in the lateral compartment (SR 0.218, p = 0.003). MRI reporting of knee osteoarthritis was moderately correlated with Outerbridge grades in the medial compartment (SR 0.451, p < 0.001), mildly correlated for both the lateral (SR 0.299, p < 0.001) and patellofemoral joint compartments (SR 0.142, p = 0.054). KL and MRI grading was moderately correlated for the medial compartment (SR 0.475, p < 0.001) and mildly correlated for the lateral compartment (SR 0.277, p < 0.001). Conclusion The ability of radiographs to represent the actual condition of knee osteoarthritis is underestimated. KL grading especially best represents the disease seen in the medial compartment of the knee joint, with a moderate correlation to Outerbridge scores given on arthroscopic assessment. We suggest that whilst MRI is a useful tool in the investigation of knee symptoms, it is often unnecessarily used in patients with OA, when in fact, radiographs alone would be sufficient. Evidence level III

Single- vs. double-dose gadolinium contrast in delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) in knee osteoarthritis: is dose reduction possible on 3-T MRI?

2018 ◽  
Vol 60 (6) ◽  
pp. 749-754
Author(s):  
Stine Hangaard ◽  
Jesper Sörensson Gade ◽  
Philip Hansen ◽  
Janus Damm Nybing ◽  
Henrik Gudbergsen ◽  
...  
Keyword(s):  
Relaxation Time ◽  
Single Dose ◽  
Knee Osteoarthritis ◽  
Weight Bearing ◽  
Relaxation Times ◽  
Lateral Compartment ◽  
Double Dose ◽  
Gadolinium Contrast ◽  
T1 Relaxation Time ◽  
T1 Relaxation

Background Reduction in gadolinium (Gd) contrast agents is wanted due to the uncertainty of the potential side effects. Purpose To investigate whether it is possible to reduce the contrast dose from conventional double dose to single dose when increasing the field strength from 1.5-T to 3-T for separating early cartilage degeneration from healthy cartilage, assessed by delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC). Material and Methods Nine patients with knee osteoarthritis (OA), Kellgren–Lawrence grade (KLG) 1–4, were recruited from an ongoing weight loss cohort study. dGEMRIC was performed at 3-T using single (0.1 mmoI/kg) and double (0.2 mmoI/kg) doses of intravenous (i.v.) Gd-DTPA2-. Regions of interest (ROls) were drawn around the posterior weight-bearing femoral knee cartilage in lateral and medial compartments. In five medial compartments ROIs could not be drawn due to severe degeneration of cartilage. T1-relaxation times were compared to previously published values from 1.5-T and to non-contrast values from 3-T. Results Mean dGEMRIC T1-relaxation time in the lateral compartment was 769 ms for single dose vs. 561 ms for double dose ( P < 0.0001); and 685 ms for single dose vs. 454 ms for double dose ( P = 0.004) in the medial compartment. Conclusion We found a dose-response relationship between single and double doses of Gd-DTPA2- using 3-T in knee OA patients, similar to the findings at 1.5-T. Compared to the T1-relaxation time at 3-T without contrast (1240 ms), this further separation between OA and normal cartilage indicates that “single dose” dGEMRIC could be sufficient for cartilage health assessment at 3-T.

Patients with lateral compartment knee osteoarthritis during arthroscopy are at highest risk of subsequent knee arthroplasty

The Knee ◽  
2020 ◽  
Vol 27 (5) ◽  
pp. 1476-1483
Author(s):  
Antonio Klasan ◽  
Sven Edward Putnis ◽  
Thomas Neri ◽  
Murilo Leie ◽  
Myles Raphael Coolican
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Lateral Compartment

Physical activity after distal femur osteotomy for the treatment of lateral compartment knee osteoarthritis

2012 ◽  
Vol 22 (7) ◽  
pp. 1607-1611 ◽  
Author(s):  
Lúcio Honório de Carvalho ◽  
Eduardo Frois Temponi ◽  
Luiz Fernando Machado Soares ◽  
Matheus Braga Jacques Gonçalves ◽  
Lincoln Paiva Costa
Keyword(s):  
Physical Activity ◽  
Knee Osteoarthritis ◽  
Distal Femur ◽  
Lateral Compartment ◽  
Distal Femur Osteotomy

Regional Cartilage Thinning Occurs First in the Walking Weight Bearing Regions of the Femur in Medial Compartment Knee Osteoarthritis

2008 ◽  
Author(s):  
Jennifer C. Erhart ◽  
Anne Mündermann ◽  
Seungbum Koo ◽  
Ben Merrick ◽  
Andrew Deagon ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Femoral Condyle ◽  
Weight Bearing ◽  
Lateral Compartment ◽  
Medial Compartment ◽  
Treatment Interventions ◽  
Knee Oa ◽  
Highest Weight ◽  
Kellgren And Lawrence ◽  
New Treatment

Osteoarthritis (OA) of the knee affects an estimated 20–40% of individuals over the age of 65 [1], and is nearly 10 times more common in the medial compartment than the lateral compartment [2]. Plain radiography measurements using the Kellgren and Lawrence (KL) scale have been the gold standard for diagnosis of knee osteoarthritis [3]. However, for new treatment interventions for medial compartment knee OA such as load modifying footwear, it would be important to know if the disease-related cartilage loss in the medial compartment occurs initially and predominantly in regions that are weight bearing during walking. Because walking results in highest weight bearing occurring in the anterior and middle regions of the femoral condyle and the anterior region of the tibial plateau, seeing a pattern of thinning in these areas would suggest that walking is an important activity for understanding both the cause and treatment of osteoarthritis.

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