A new method to measure anatomic knee alignment for large studies of OA: data from the Osteoarthritis Initiative

Iranpour-Boroujeni, T.; Li, J.; Lynch, J.A.; Nevitt, Michael C.; Duryea, J.

doi:10.1016/j.joca.2014.06.011

Cited by 39 publications

(71 citation statements)

References 16 publications

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“…Baseline fixed flexion radiographs were used to quantify the new FTA measurement (Version 0.1) [12] and currently, FTA measures are available for the baseline visit only (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

“…This method does not define FTA by the shaft but utilizes more local information around the joint space and femoral condyles [12][13][14]. The authors reported greater intra-rater and inter-rater reliability [12] for measuring FTA than the traditional method in participants with knee OA, and somewhat greater correlation with HKA (r ¼ 0.75) than for the traditional FTA measurements (r ¼ 0.68). However, the offset between the new FTA measurement methodology and HKA measures has not been studied.…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, an offset between these measurement methods [6,10,11] has previously been reported, with FTA being skewed in the valgus direction (i.e., FTA: 31-51) compared to knees with neutral HKA (i.e., HKA ¼ 01). Despite this systematic difference, correlations between HKA and FTA have been reported to be moderate to high (r: 0.46-0.93) but vastly inconsistent between studies [5][6][7][9][10][11][12]. The method proposed by Kraus et al [6] originally defined FTA as the angle between the distal femur and proximal tibia, (i.e., the traditional method).…”

Section: Introductionmentioning

confidence: 99%

“…The method proposed by Kraus et al [6] originally defined FTA as the angle between the distal femur and proximal tibia, (i.e., the traditional method). However, a novel, highly automated method for measuring FTA was recently presented by Iranpour-Boroujeni et al [12] and alignment data obtained with this method are now available for most of the osteoarthritis initiative (OAI) cohort. This method does not define FTA by the shaft but utilizes more local information around the joint space and femoral condyles [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

“…However, a novel, highly automated method for measuring FTA was recently presented by Iranpour-Boroujeni et al [12] and alignment data obtained with this method are now available for most of the osteoarthritis initiative (OAI) cohort. This method does not define FTA by the shaft but utilizes more local information around the joint space and femoral condyles [12][13][14]. The authors reported greater intra-rater and inter-rater reliability [12] for measuring FTA than the traditional method in participants with knee OA, and somewhat greater correlation with HKA (r ¼ 0.75) than for the traditional FTA measurements (r ¼ 0.68).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Sensitivity of different measures of frontal plane alignment to medial and lateral joint space narrowing: From the osteoarthritis initiative

Moyer

Wirth

Eckstein

2015

Seminars in Arthritis and Rheumatism

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“…Baseline fixed flexion radiographs were used to quantify the new FTA measurement (Version 0.1) [12] and currently, FTA measures are available for the baseline visit only (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Sensitivity of different measures of frontal plane alignment to medial and lateral joint space narrowing: From the osteoarthritis initiative

Moyer

Wirth

Eckstein

2015

Seminars in Arthritis and Rheumatism

View full text Add to dashboard Cite

Longitudinal Changes in Magnetic Resonance Imaging–Based Measures of Femorotibial Cartilage Thickness as a Function of Alignment and Obesity: Data From the Osteoarthritis Initiative

Moyer

Wirth

Eckstein

2017

Arthritis Care & Research

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Objective To investigate the interaction between malalignment and body mass index (BMI) on cartilage thickness change in patients with knee osteoarthritis (OA). Methods Femorotibial cartilage thickness was measured from baseline to 2 years in 558 knees with radiographic OA. Cartilage thickness was determined in the central weight-bearing medial femorotibial cartilage (cMFTC) and lateral (cLFTC) compartments. Femorotibial angle (FTA) was stratified into neutral, minor, and definite malalignment. BMI was stratified using World Health Organization classifications for normal, overweight, and obese. Multivariable linear regression models were used to investigate the interaction between alignment and BMI, adjusting for age, sex, and disease severity. Results There was no significant interaction for continuous measures of alignment and BMI (P = 0.301 for cMFTC and P = 0.852 for cLFTC). Using BMI tertiles, the association between alignment and medial or lateral cartilage thickness loss was not moderated by BMI, despite a significant association of malalignment with greater cartilage thickness loss (P ≤ 0.005). Using FTA tertiles, the association between BMI and medial cartilage thickness loss was approximately 3 times greater in knees with definite malalignment (P = 0.149) and approximately 5 times greater in knees with minor malalignment (P = 0.006). Specifically, knees with minor varus significantly modified this relationship (P = 0.021). Conclusion Malalignment was significantly associated with cartilage thickness loss per degree increase in malalignment, but was not moderated by BMI. BMI was significantly associated with greater rates of medial cartilage thickness loss per unit increase in BMI but only in knees with minor varus malalignment. These findings have implications for better understanding patient subgroups and intervention strategies targeting risk factors for knee OA.

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Trajectories of Structural Disease Progression in Knee Osteoarthritis

Collins

Neogi

Losina

2021

Arthritis Care & Research

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Objective Knee osteoarthritis (OA) is a heterogeneous disease, with most patients experiencing slow disease progression and some with rapid deterioration. We aimed to identify groups of patients with symptomatic knee OA experiencing rapid structural progression. Methods We selected participants from the Osteoarthritis Initiative with baseline Kellgren/Lawrence (K/L) grades 1–3 and knee pain, and with joint space width (JSW) on fixed‐flexion knee radiographs assessed at baseline and with ≥1 follow‐up over 8 years. We used latent class growth analysis to identify subgroups of JSW progression, jointly modeling time to knee replacement (KR) to account for potential informative dropouts. After identifying trajectories, we used logistic regression to assess the association between baseline characteristics and the JSW trajectory group. Results We used data from 1,578 participants. Baseline radiographic severity was K/L grade 1 in 17%, K/L grade 2 in 50%, and K/L grade 3 in 33%. We identified 3 distinct JSW trajectories: 86% stable, 6% with stable JSW followed by late progression, and 8% with early progression. Incorporating information about KR resulted in 47% of KRs initially classified as stable being reclassified to 1 of the progressing trajectories. Prior knee surgery was associated with being in the late‐progressing versus the stable trajectory, while obesity was associated with being in the early‐progressing versus stable trajectory. Conclusion In addition to a subgroup of individuals experiencing early structural progression, 8‐year longitudinal data allowed the identification of a late‐progressing trajectory. Incorporating information about KR was important to properly identify longitudinal structural trajectories in knee OA.

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A new method to measure anatomic knee alignment for large studies of OA: data from the Osteoarthritis Initiative

Abstract: Since it is largely automated and uses unambiguous anatomical landmarks, the new method is highly reproducible and can be made on a standard posteroanterior (PA) knee radiograph by a relatively unskilled reader.

Cited by 39 publications

References 16 publications

Sensitivity of different measures of frontal plane alignment to medial and lateral joint space narrowing: From the osteoarthritis initiative

Sensitivity of different measures of frontal plane alignment to medial and lateral joint space narrowing: From the osteoarthritis initiative

Longitudinal Changes in Magnetic Resonance Imaging–Based Measures of Femorotibial Cartilage Thickness as a Function of Alignment and Obesity: Data From the Osteoarthritis Initiative

Trajectories of Structural Disease Progression in Knee Osteoarthritis

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