scholarly journals Is it possible to use stress radiographs as a tool to diagnose medial meniscus posterior root tears?

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0007
Author(s):  
Ali Engin Daştan ◽  
Elcil Kaya Biçer ◽  
Hüseyin Kaya ◽  
Emin Taşkıran
Keyword(s):  
Medial Meniscus ◽  
Weight Bearing ◽  
Joint Space Width ◽  
Joint Space ◽  
X Rays ◽  
Meniscal Extrusion ◽  
Valgus Stress ◽  
Varus Stress ◽  
The Difference ◽  
Space Width

Aim: Medial meniscus posterior root tear (MMPRT) causes meniscal extrusion, loss of meniscus function, arthritic changes. Clinical history, physical examination and magnetic resonance imaging (MRI) findings are useful for the diagnosis of MMPRT. The aim of this study is to evaluate the utility of stress X-rays in the diagnosis of MMPRT. Methods: Twenty patients who had undergone high tibial osteotomy between March 2015 and May 2016 and whose preoperative bilateral varus and valgus stress x-rays (Telos device) along with weight bearing x-rays were available were included. These patients were grouped into two according to integrity of posterior roots of their medial menisci; there were ten patients both in the study and control groups. Lateral joint space width (LJW) on varus stress x-rays, medial joint space width (MJW) on valgus stress x-rays as well as LJW and MJW on weight bearing x-rays were measured bilaterally. Intragroup comparisons of joint space widths between index and opposite knees were performed. Differences of MJW and LJW between index and opposite knees were calculated. Differences of joint space widths between stress x-rays and weight bearing x-rays were also calculated. The changes in joint space widths between the two groups were compared. Statistical analyses were performed utilizing SPSS 18.0. Significance level was set at 0.05. Results: In MMPRT group, opening of LJ space of index knees under varus stress was greater than that of opposite knees (Index: (mean±SD) 10,27±1,17 mm, opposite: 8,61±1,37 mm; p<0,0001). In the control group the difference was not significant (Index: 9,29±2,55 mm, opposite: 9,68±1,44 mm; p=0,566). The difference in the opening of LJW (under varus stress) between index and opposite knees was significantly greater in the study group (p=0,013). The difference between LJW under weight-bearing and varus stress conditions was significantly greater in the study group. (Study: 3,64±0.217 mm, control:2,28±0,182 mm, p=0.018). Conclusions: The findings of this study showed that in patients who had MMPRTs, an increased opening in the LJW was observed under varus stress conditions. This may be relevant with the fact that when varus stress is applied, meniscal extrusion is increased in case of a MMPRT. Stress x-rays could be a useful tool in the diagnosis of MMPRTs. Further studies are needed to determine the sensitivity and specificity of this diagnostic tool.

Quantitative Evaluation of Joint Space Width in the Lateral Compartment after Medial Unicompartmental Knee Arthroplasty: Comparison of Three Radiographic Views

2017 ◽  
Vol 31 (08) ◽  
pp. 730-735
Author(s):  
Ju'an Yue ◽  
Wanshou Guo ◽  
Fuyin Wan ◽  
Pengfei Wen ◽  
Zhaohui Liu ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Weight Bearing ◽  
Joint Space Width ◽  
Lateral Compartment ◽  
Joint Space ◽  
Valgus Stress ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
Group A ◽  
Group B ◽  
Space Width

AbstractLateral compartment cartilage deterioration is the most common complication affecting medial unicompartmental knee arthroplasty (UKA) survivorship. The purpose of this study was to determine the best method of judging the degeneration of cartilage in the lateral compartment after medial UKA through analysis of different radiographic views. Forty-two participants were divided into two groups. Patients in Group A were followed for at least 10 months after undergoing a medial UKA (mean: 17.67 ± 7.65 months, range: 10–24 months), whereas those in Group B were evaluated 3 days after surgery. Joint space width in the lateral compartment of all patients was evaluated using three types of knee radiographs: weight-bearing anterior posterior (AP), supine AP, and supine valgus stress. No difference in joint space width in the lateral compartment after medial UKA was found for the three kinds of radiographs in Group A (F = 0.97, p = 0.39) and Group B (F = 1.499, p = 0.233). After evaluating the patients 3 days after surgery or following them for approximately 18 months after medial UKA, we determined that weight-bearing AP, supine AP, and supine valgus stress knee radiographs were comparable when used to assess residual cartilage thickness of the lateral compartment.

scholarly journals Quantitative Three-dimensional Assessment of Knee Joint Space Width from Weight-bearing CT

Radiology ◽  
2021 ◽  
pp. 203928
Author(s):  
Tom D. Turmezei ◽  
Samantha B. Low ◽  
Simon Rupret ◽  
Graham M. Treece ◽  
Andrew H. Gee ◽  
...  
Keyword(s):  
Knee Joint ◽  
Weight Bearing ◽  
Three Dimensional ◽  
Joint Space Width ◽  
Joint Space ◽  
Dimensional Assessment ◽  
Space Width

Two-Year Outcomes After Meniscoplasty by Capsular Advancement With the Application of Arthroscopic Centralization Technique for Lateral Compartment Knee Osteoarthritis

2020 ◽  
Vol 48 (13) ◽  
pp. 3154-3162
Author(s):  
Hideyuki Koga ◽  
Tomomasa Nakamura ◽  
Hiroki Katagiri ◽  
Yusuke Nakagawa ◽  
Nobutake Ozeki ◽  
...  
Keyword(s):  
Joint Space Width ◽  
Lateral Compartment ◽  
Joint Space ◽  
Lysholm Score ◽  
Sports Performance ◽  
Resonance Imaging ◽  
Meniscal Extrusion ◽  
Radiographic Outcomes ◽  
Subjective Score ◽  
Space Width

Background: A high prevalence of osteoarthritis (OA) progression in patients with lateral meniscal defects has been reported. However, optimal management techniques for active patients remain ill-defined. Hypothesis: Meniscoplasty by capsular advancement with the application of the centralization technique would improve clinical and radiological outcomes in patients with lateral compartment OA attributed to lateral meniscal defects. Study Design: Case series; Level of evidence, 4. Methods: A total of 27 patients were enrolled who had undergone meniscoplasty by capsular advancement for lateral compartment OA attributed to lateral meniscal defects. In these patients, the meniscotibial capsule was released from the tibia and advanced with the remaining meniscus onto the rim of the tibial plateau to reform a meniscus-like configuration. Measures of clinical outcomes included clinical examination, Lysholm score, International Knee Documentation Committee (IKDC) subjective score, Knee injury and Osteoarthritis Outcome Score (KOOS), subjective rating scales regarding recovery of the operated knee, and sports performance level. Measures of radiographic outcomes included meniscal extrusion width or regeneration of the meniscus-like tissue on magnetic resonance imaging and lateral joint space width on standing extension anteroposterior and Rosenberg views. All clinical and radiographic outcomes were reported preoperatively and 2 years postoperatively, except magnetic resonance imaging findings, which were reported preoperatively and 1 year postoperatively. Results: The clinical outcomes were significantly improved 2 years postoperatively as compared with baseline: Lysholm score, IKDC subjective score, and KOOS subscores (all P < .0001). The patients’ subjective recovery ( P < .0001) and sports performance level ( P < .0001) were also improved. One year postoperatively, 10 of 11 patients who had no meniscus remaining at the middle segment showed more than one-third the volume of meniscal tissue–like regeneration, and meniscal extrusion width was significantly reduced as compared with baseline in the remaining 16 patients ( P = .0006). Joint space width increased at 2 years on the standing anteroposterior view ( P < .0001) and the Rosenberg view ( P = .0001). Conclusion: Meniscoplasty of the lateral meniscus by capsular advancement improved clinical and radiographic outcomes at 2-year follow-up in patients with lateral compartment OA attributed to lateral meniscal defects.

scholarly journals Tomosynthesis can facilitate accurate measurement of joint space width under the condition of the oblique incidence of X-rays in patients with rheumatoid arthritis

2016 ◽  
Vol 89 (1062) ◽  
pp. 20150967 ◽  
Author(s):  
Yohei Ono ◽  
Rina Kashihara ◽  
Nobutoshi Yasojima ◽  
Hideki Kasahara ◽  
Yuka Shimizu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Oblique Incidence ◽  
Joint Space Width ◽  
Joint Space ◽  
X Rays ◽  
Space Width

scholarly journals Arthroscopic pie-crusting release of the posteromedial complex of the knee for surgical treatment of the medial meniscus injury

2020 ◽  
Author(s):  
Xu Han ◽  
Peizhao Wang ◽  
Jinyang Yu ◽  
Xiao Wang ◽  
Honglue Tan
Keyword(s):  
Medial Meniscus ◽  
Joint Space Width ◽  
Posterior Part ◽  
Scoring Systems ◽  
Clinical Results ◽  
Joint Space ◽  
Valgus Stress ◽  
Radiographic Measurements ◽  
Meniscal Surgery

Abstract Background: Arthroscopic narrow posteromedial gap of the knee may cause the failure of meniscus operation. The posteromedial complex (PMC) of the knee, including the posterior part of MCL and posterior oblique ligament, has a restrictive effect on the opening of the posteromedial gap of the knee in the half-extension position. Thus, we evaluated the radiological and clinical results of pie-crusting release of PMC for arthroscopic meniscal surgery in tight knees.Methods : Sixty patients with posterior injury of the medial meniscus were reviewed. All patients accepted arthroscopic pie-crusting release of the PMC. Fourty patients accepted meniscoplasty, and 20 patients accepted meniscuc suturing. To evaluate the arthroscopic opening of the medial gap in 20°half-extension under 11-kg valgus stress, the width of the medial space before and after release were measured. During follow-up, the medial stability was evaluated by radiographic measurements of the joint space width (JSW) in 20°half-extension. MRI was conducted to evaluate the healing of MCL and meniscus. Knee functions were evaluated using VAS, Lysholm, IKDC and Tegner scoring systems. Results: In all patients, meniscus operations were performed without iatrogenic cartilage injury. After PMC release, the arthroscopic width of the medial space was 5.7 ±0.5 mm, showing larger than that before release (2.5 ± 0.5 mm) (p < 0.01). The follow-up time was 21.93±7.04 months, there was no residual valgus laxity of the knee. The radiographic JSW was 5.97 ± 0.8 mm preoperatively, 9.2 ± 1.1 mm in the postoperative 1st week, and 6.1±0.9 mm in the postoperative 3rd months, showing no differences between pre- and postoperative 3rd month (p > 0.05). For sutured meniscus, MRI showed healing in 15 patients while five had two-grade abnormal signals. VAS, Lysholm, IKDC and Tegner scores were 1.80±0.51, 80.08±3.74, 82.17±4.64 and 5.48±0.59, respectively, showing significant differences compared with the preoperative scores (5.57±0.69, 48.17±4.22, 51.42±4.02 and 3.20±0.68, respectively) (P < 0.01).Conclusion s: Pie-crusting release of PMC can increase the posteromedial space and improve the visual field of the knee under arthroscopy, and this technique do neither produce residual valgus instability of the knee nor affect clinical outcome at the final follow-up.

scholarly journals Short-term changes in radiographic joint space width after jiggling exercise as conservative treatment for hip osteoarthritis: A retrospective case series of nine patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253643
Author(s):  
Hisayoshi Yoshizuka ◽  
Takanori Sato ◽  
Junya Murakami ◽  
Tsubasa Mitsutake ◽  
Masao Hiromatsu
Keyword(s):  
Conservative Treatment ◽  
Weight Bearing ◽  
Joint Space Width ◽  
Case Series ◽  
Hip Osteoarthritis ◽  
Joint Space ◽  
Post Discharge ◽  
Retrospective Case ◽  
Terminal Stage ◽  
Space Width

Jiggling exercise is a conservative treatment for hip osteoarthritis, which involves continuous shaking of the foot and leg in small oscillations while seated. Previous studies have shown beneficial effects of jiggling exercises for outpatients with advanced- and terminal-stage hip osteoarthritis when performed for longer than 1 year, including increases in joint space width and remission of symptoms. We aimed to use the data from our own treatment to evaluate the short-term impact of intensive jiggling exercises on inpatients with hip osteoarthritis to further examine the clinical utility of this exercise. This retrospective case series study included nine patients (57 ± 12 years) with nine hip joints with advanced- or terminal-stage hip osteoarthritis who performed continuous daily jiggling exercises, beginning from day of hospitalization to 6 months post-discharge. Jiggling exercise was performed seated, using the KENKO YUSURI® automated heel vibrating machine at 3.3–5.0 Hz. The patients were also instructed against weight-bearing during hospitalization. The values of radiographic joint space width and Japanese Orthopaedic Association hip score for pain at hospital admission, discharge, and at the 6-month post-discharge checkup were evaluated. Although the hospitalization period and daily time spent performing the jiggling exercise varied in each case (27–98 days and 2–6 hours, respectively), the joint space width increased in all patients and there was an improvement in the hip pain scores in eight patients. The mean values of the minimum joint space width and hip pain scores at discharge were the highest compared to those at hospital admission and 6 months post-discharge. Our results suggest that intensive jiggling exercise for inpatients with advanced- and terminal-stage hip osteoarthritis leads to earlier improvement in joint space width and pain. Daily jiggling exercise for an adequate duration or in combination with non-weight-bearing practices may be a feasible conservative treatment for hip osteoarthritis.

scholarly journals Comparison between 2D radiographic weight-bearing joint space width and 3D MRI non-weight-bearing cartilage thickness measures in the knee using non-weight-bearing 2D and 3D CT as an intermediary

2021 ◽  
Vol 12 ◽  
pp. 204062232110378
Author(s):  
Mylène P. Jansen ◽  
Simon C. Mastbergen ◽  
Felix Eckstein ◽  
Ronald J. van Heerwaarden ◽  
Sander Spruijt ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Joint Space Width ◽  
Surrogate Marker ◽  
Joint Space ◽  
Cartilage Thickness ◽  
Poor Correlation ◽  
3D Ct ◽  
Longitudinal Changes ◽  
The Impact ◽  
Space Width

Background: In knee osteoarthritis, radiographic joint space width (JSW) is frequently used as a surrogate marker for cartilage thickness; however, longitudinal changes in radiographic JSW have shown poor correlations with those of magnetic resonance imaging (MRI) cartilage thickness. There are fundamental differences between the techniques: radiographic JSW represents two-dimensional (2D), weight-bearing, bone-to-bone distance, while on MRI three-dimensional (3D) non-weight-bearing cartilage thickness is measured. In this exploratory study, computed tomography (CT) was included as a third technique, as it can measure bone-to-bone under non-weight-bearing conditions. The objective was to use CT to compare the impact of weight-bearing versus non-weight-bearing, as well as bone-to-bone JSW versus actual cartilage thickness, in the knee. Methods: Osteoarthritis patients ( n = 20) who were treated with knee joint distraction were included. Weight-bearing radiographs, non-weight-bearing MRIs and CTs were acquired before and 2 years after treatment. The mean radiographic JSW and cartilage thickness of the most affected compartment were measured. From CT, the 3D median JSW was calculated and a 2D projectional image was rendered, positioned similarly and measured identically to the radiograph. Pearson correlations between the techniques were derived, both cross-sectionally and longitudinally. Results: Fourteen patients could be analyzed. Cross-sectionally, all comparisons showed moderate to strong significant correlations (R = 0.43–0.81; all p < 0.05). Longitudinal changes over time were small; only the correlations between 2D CT and 3D CT (R = 0.65; p = 0.01) and 3D CT and MRI (R = 0.62; p = 0.02) were statistically significant. Conclusion: The poor correlation between changes in radiographic JSW and MRI cartilage thickness appears primarily to result from the difference in weight-bearing, and less so from measuring bone-to-bone distance versus cartilage thickness.

scholarly journals Arthroscopic pie-crusting release of the posteromedial c omplex  of the knee for surgical treatment of medial meniscus injury

2020 ◽  
Author(s):  
Xu Han ◽  
Peizhao Wang ◽  
Jinyang Yu ◽  
Xiao Wang ◽  
Honglue Tan
Keyword(s):  
Medial Meniscus ◽  
Joint Space Width ◽  
Posterior Part ◽  
Clinical Results ◽  
Joint Space ◽  
Valgus Stress ◽  
Radiographic Measurements ◽  
Before And After ◽  
Meniscal Surgery

Abstract Background: The posteromedial complex (PMC), including the posterior part of the MCL and the posterior oblique ligament (POL), has a restrictive effect on the opening of the posteromedial gap of the knee in the half-extension position. We evaluated the radiological and clinical results of pie-crusting release of the PMC for arthroscopic meniscal surgery in tight knees.Methods: Sixty patients with posterior injury of the medial meniscus were reviewed. All patients accepted arthroscopic pie-crusting release of the PMC. Fourty patients accepted meniscoplasty, and 20 patients accepted meniscal suturing. To evaluate the arthroscopic opening of the medial gap in 20° half-extension under 11-kg valgus stress, the width of the medial space before and after release were measured. During follow-up, the medial stability was evaluated by radiographic measurements of the joint space width (JSW). MRI was conducted to evaluate healing of the MCL and meniscus. Knee functions were evaluated using VAS, Lysholm, IKDC and Tegner scoring systems.Results: In all patients, meniscus operations were performed without iatrogenic cartilage injury. After PMC release, the arthroscopic width of the medial space was 5.7 ± 0.5 mm, larger than that before release (2.5 ± 0.5 mm, p < 0.01). The follow-up time was 21.93 ± 7.04 months, there was no residual valgus laxity of the knee. The radiographic JSW was 5.97 ± 0.8 mm preoperatively, 9.2 ± 1.1 mm in the 1st week postoperatively, and 6.1 ± 0.9 mm by the 3rd postoperative month, showing no differences between preoperative and 3 months postoperative measurement (p > 0.05). For sutured meniscus, MRI showed healing in 15 patients while five had two-grade abnormal signals. VAS, Lysholm, IKDC and Tegner scores were 1.80 ± 0.51, 80.08 ± 3.74, 82.17 ± 4.64 and 5.48 ± 0.59, respectively, showing significant differences compared with the preoperative scores (5.57 ± 0.69, 48.17 ± 4.22, 51.42 ± 4.02 and 3.20 ± 0.68, respectively, P < 0.01).Conclusions: Pie-crusting release of the PMC can increase the posteromedial space and improve the visual field of the knee under arthroscopy, while neither causing no residual valgus instability of the knee nor affecting the clinical outcome at the final follow-up.

Sign in / Sign up

Export Citation Format

Share Document