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A comparison of radiographic anatomic axis knee alignment measurements and cross-sectional associations with knee osteoarthritis

OBJECTIVE: Malalignment is associated with knee osteoarthritis (KOA), however, the optimal anatomic axis (AA) knee alignment measurement on a standard limb radiograph (SLR) is unknown. This study compares one-point (1P) and two-point (2P) AA methods using three knee joint centre locations and examin...

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Autores principales: Goulston, L.M., Sanchez-Santos, M.T., D'Angelo, S., Leyland, K.M., Hart, D.J., Spector, T.D., Cooper, C., Dennison, E.M., Hunter, D., Arden, N.K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: W.B. Saunders For The Osteoarthritis Research Society 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4819520/
https://www.ncbi.nlm.nih.gov/pubmed/26700504
http://dx.doi.org/10.1016/j.joca.2015.11.009
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author Goulston, L.M.
Sanchez-Santos, M.T.
D'Angelo, S.
Leyland, K.M.
Hart, D.J.
Spector, T.D.
Cooper, C.
Dennison, E.M.
Hunter, D.
Arden, N.K.
author_facet Goulston, L.M.
Sanchez-Santos, M.T.
D'Angelo, S.
Leyland, K.M.
Hart, D.J.
Spector, T.D.
Cooper, C.
Dennison, E.M.
Hunter, D.
Arden, N.K.
author_sort Goulston, L.M.
collection PubMed
description OBJECTIVE: Malalignment is associated with knee osteoarthritis (KOA), however, the optimal anatomic axis (AA) knee alignment measurement on a standard limb radiograph (SLR) is unknown. This study compares one-point (1P) and two-point (2P) AA methods using three knee joint centre locations and examines cross-sectional associations with symptomatic radiographic knee osteoarthritis (SRKOA), radiographic knee osteoarthritis (RKOA) and knee pain. METHODS: AA alignment was measured six different ways using the KneeMorf software on 1058 SLRs from 584 women in the Chingford Study. Cross-sectional associations with principal outcome SRKOA combined with greatest reproducibility determined the optimal 1P and 2P AA method. Appropriate varus/neutral/valgus alignment categories were established using logistic regression with generalised estimating equation models fitted with restricted cubic spline function. RESULTS: The tibial plateau centre displayed greatest reproducibility and associations with SRKOA. As mean 1P and 2P values differed by >2°, new alignment categories were generated for 1P: varus <178°, neutral 178–182°, valgus >182° and for 2P methods: varus <180°, neutral 180–185°, valgus >185°. Varus vs neutral alignment was associated with a near 2-fold increase in SRKOA and RKOA, and valgus vs neutral for RKOA using 2P method. Nonsignificant associations were seen for 1P method for SRKOA, RKOA and knee pain. CONCLUSIONS: AA alignment was associated with SRKOA and the tibial plateau centre had the strongest association. Differences in AA alignment when 1P vs 2P methods were compared indicated bespoke alignment categories were necessary. Further replication and validation with mechanical axis alignment comparison is required.
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spelling pubmed-48195202016-04-14 A comparison of radiographic anatomic axis knee alignment measurements and cross-sectional associations with knee osteoarthritis Goulston, L.M. Sanchez-Santos, M.T. D'Angelo, S. Leyland, K.M. Hart, D.J. Spector, T.D. Cooper, C. Dennison, E.M. Hunter, D. Arden, N.K. Osteoarthritis Cartilage Article OBJECTIVE: Malalignment is associated with knee osteoarthritis (KOA), however, the optimal anatomic axis (AA) knee alignment measurement on a standard limb radiograph (SLR) is unknown. This study compares one-point (1P) and two-point (2P) AA methods using three knee joint centre locations and examines cross-sectional associations with symptomatic radiographic knee osteoarthritis (SRKOA), radiographic knee osteoarthritis (RKOA) and knee pain. METHODS: AA alignment was measured six different ways using the KneeMorf software on 1058 SLRs from 584 women in the Chingford Study. Cross-sectional associations with principal outcome SRKOA combined with greatest reproducibility determined the optimal 1P and 2P AA method. Appropriate varus/neutral/valgus alignment categories were established using logistic regression with generalised estimating equation models fitted with restricted cubic spline function. RESULTS: The tibial plateau centre displayed greatest reproducibility and associations with SRKOA. As mean 1P and 2P values differed by >2°, new alignment categories were generated for 1P: varus <178°, neutral 178–182°, valgus >182° and for 2P methods: varus <180°, neutral 180–185°, valgus >185°. Varus vs neutral alignment was associated with a near 2-fold increase in SRKOA and RKOA, and valgus vs neutral for RKOA using 2P method. Nonsignificant associations were seen for 1P method for SRKOA, RKOA and knee pain. CONCLUSIONS: AA alignment was associated with SRKOA and the tibial plateau centre had the strongest association. Differences in AA alignment when 1P vs 2P methods were compared indicated bespoke alignment categories were necessary. Further replication and validation with mechanical axis alignment comparison is required. W.B. Saunders For The Osteoarthritis Research Society 2016-04 /pmc/articles/PMC4819520/ /pubmed/26700504 http://dx.doi.org/10.1016/j.joca.2015.11.009 Text en Crown Copyright © Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Goulston, L.M.
Sanchez-Santos, M.T.
D'Angelo, S.
Leyland, K.M.
Hart, D.J.
Spector, T.D.
Cooper, C.
Dennison, E.M.
Hunter, D.
Arden, N.K.
A comparison of radiographic anatomic axis knee alignment measurements and cross-sectional associations with knee osteoarthritis
title A comparison of radiographic anatomic axis knee alignment measurements and cross-sectional associations with knee osteoarthritis
title_full A comparison of radiographic anatomic axis knee alignment measurements and cross-sectional associations with knee osteoarthritis
title_fullStr A comparison of radiographic anatomic axis knee alignment measurements and cross-sectional associations with knee osteoarthritis
title_full_unstemmed A comparison of radiographic anatomic axis knee alignment measurements and cross-sectional associations with knee osteoarthritis
title_short A comparison of radiographic anatomic axis knee alignment measurements and cross-sectional associations with knee osteoarthritis
title_sort comparison of radiographic anatomic axis knee alignment measurements and cross-sectional associations with knee osteoarthritis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4819520/
https://www.ncbi.nlm.nih.gov/pubmed/26700504
http://dx.doi.org/10.1016/j.joca.2015.11.009
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