The Value of Valgus Stress Radiographs in the Workup for Medial Unicompartmental Arthritis

Waldstein, Wenzel; Monsef, Jad Bou; Buckup, Johannes; Boettner, Friedrich

doi:10.1007/s11999-013-3212-3

Cited by 46 publications

(26 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Twenty-seven studies comparing different views for knee OA were included. In this context, all studies involving the tibiofemoral compartment considered weightbearing views, both in extension and various degrees of flexion 7 8 10 17 25 118 123 137–147. Studies comparing fully extended and flexed views in general showed a moderate to good agreement between the two projections and similar sensitivity and specificity in detecting cartilage damage, considering arthroscopic findings as reference 117 138 139 148 149.…”

Section: Resultsmentioning

confidence: 99%

EULAR recommendations for the use of imaging in the clinical management of peripheral joint osteoarthritis

et al. 2017

View full text Add to dashboard Cite

The increased information provided by modern imaging has led to its more extensive use. Our aim was to develop evidence-based recommendations for the use of imaging in the clinical management of the most common arthropathy, osteoarthritis (OA). A task force (including rheumatologists, radiologists, methodologists, primary care doctors and patients) from nine countries defined 10 questions on the role of imaging in OA to support a systematic literature review (SLR). Joints of interest were the knee, hip, hand and foot; imaging modalities included conventional radiography (CR), MRI, ultrasonography, CT and nuclear medicine. PubMed and EMBASE were searched. The evidence was presented to the task force who subsequently developed the recommendations. The strength of agreement for each recommendation was assessed. 17 011 references were identified from which 390 studies were included in the SLR. Seven recommendations were produced, covering the lack of need for diagnostic imaging in patients with typical symptoms; the role of imaging in differential diagnosis; the lack of benefit in monitoring when no therapeutic modification is related, though consideration is required when unexpected clinical deterioration occurs; CR as the first-choice imaging modality; consideration of how to correctly acquire images and the role of imaging in guiding local injections. Recommendations for future research were also developed based on gaps in evidence, such as the use of imaging in identifying therapeutic targets, and demonstrating the added value of imaging. These evidence-based recommendations and related research agenda provide the basis for sensible use of imaging in routine clinical assessment of people with OA.

show abstract

Section: Resultsmentioning

confidence: 99%

EULAR recommendations for the use of imaging in the clinical management of peripheral joint osteoarthritis

et al. 2017

View full text Add to dashboard Cite

show abstract

“…15,18 Tashiro et al 19 suggested that the mean post-operative limb alignment demonstrated a significantly strong correlation with the values on the pre-operative valgus stress radiographs, while the correlation between both the pre- and the post-operative standing alignment, was moderate. A neutral, or slight under correction is recommended as an ideal post-operative coronal alignment.…”

Section: Discussionmentioning

confidence: 99%

“…If the mechanical axis of the leg was passed at the point from medial 40% to 60% of the knee joint surface on the valgus stress long-leg radiograph, the case was included. 15 Exclusion criteria were inflammatory joint diseases or severe osteoporosis, previous high tibial osteotomy and septic lesion, severe obesity > 35 of body mass index, and severe bone defect > 10 mm. There was no case of arthroplasty for lateral compartment OA.…”

Section: Methodsmentioning

confidence: 99%

Correction of coronal alignment correlates with reconstruction of joint height in unicompartmental knee arthroplasty

Kuwashima

Okazaki

Tashiro

et al. 2015

Bone & Joint Research

View full text Add to dashboard Cite

ObjectivesBecause there have been no standard methods to determine pre-operatively the thickness of resection of the proximal tibia in unicompartmental knee arthroplasty (UKA), information about the relationship between the change of limb alignment and the joint line elevation would be useful for pre-operative planning. The purpose of this study was to clarify the correlation between the change of limb alignment and the change of joint line height at the medial compartment after UKA.MethodsA consecutive series of 42 medial UKAs was reviewed retrospectively. These patients were assessed radiographically both pre- and post-operatively with standing anteroposterior radiographs. The thickness of bone resection at the proximal tibia and the distal femur was measured radiographically. The relationship between the change of femorotibial angle (δFTA) and the change of joint line height, was analysed.ResultsThe mean pre- and post-operative FTA was 180.5° (172.2° to 184.8°) and 175.0° (168.5° to 178.9°), respectively. The mean δFTA was 5.5° (2.3° to 10.1°). The joint line elevation of the tibia (JLET) was 4.4 mm (2.1 to 7.8). The δFTA was correlated with the JLET (correlation coefficient 0.494, p = 0.0009).ConclusionsThis study indicated that there is a significant correlation between the change of limb alignment and joint line elevation. This observation suggests that it is possible to know the requirement of elevation of the joint line to obtain the desired correction of limb alignment, and to predict the requirement of bone resection of the proximal tibia pre-operatively.Cite this article: Bone Joint Res 2015;4:128–133

show abstract

“…Stress radiographs were not available, however Waldstein et al . [21] reported that valgus stress radiographs provide no additional diagnostic information in lateral cartilage assessment in comparison to AP radiographs [3]. Data on Caucasian patients were derived from the literature and there was no matched comparative group in the current study [4].…”

Section: Discussionmentioning

confidence: 99%

What Percentage of Patients is a Candidate for Unicompartmental Knee Replacement at a Chinese Arthroplasty Center?

Xiao

Zhai

et al. 2018

TOORTHJ

Self Cite

View full text Add to dashboard Cite

Background:Data on indication of Unicompartmental Knee Arthroplasty (UKA) in the Asian population are currently not available. The current paper evaluates patients undergoing knee replacement at a Chinese Orthopaedic Specialty Hospital to report the percentage of patients who meet radiographic and clinical indication criteria for UKA.Methods:Over a one-year period 463 consecutive patients (515 knees) underwent primary knee replacement surgery. Clinical data were recorded and preoperative radiographs were assessed. Patients were classified as suitable candidates for UKA based on the degree of deformity, preoperative ROM and radiographic appearance of osteoarthritis. The different indication criteria for body weight and extend of patellofemoral osteoarthritis as reported by Kozinn and Scott as well as the Oxford Group were applied.Results:160 knees (31%) were excluded because of inflammatory and posttraumatic arthritis. 55 knees had to be excluded because of incomplete radiographs. Of the remaining 300 knees with osteoarthritis, 241 knees were excluded because of extend of deformity (n=156), decreased range of motion (n=119), advanced patellofemoral arthritis with bone loss (n=11) and AP instability (n=1). Of the remaining 63 knees, 54 knees (18%) met the modified Oxford criteria for mobile UKA and only 25 knees (8%) met the Scott and Kozinn criteria for fixed UKA.Conclusion:The current paper suggests that in comparison to Caucasian population, only a smaller percentage of patients at a Chinese Orthopaedic Specialty Hospital meet the indication criteria for UKA. Therefore, it might make sense to concentrate UKA surgeries in high volume centers.

show abstract

The Value of Valgus Stress Radiographs in the Workup for Medial Unicompartmental Arthritis

Abstract: Valgus stress radiographs provided no added benefit to the radiographic assessment of the lateral compartment cartilage and regarding the correctability of the varus deformity.

Cited by 46 publications

References 27 publications

EULAR recommendations for the use of imaging in the clinical management of peripheral joint osteoarthritis

EULAR recommendations for the use of imaging in the clinical management of peripheral joint osteoarthritis

Correction of coronal alignment correlates with reconstruction of joint height in unicompartmental knee arthroplasty

What Percentage of Patients is a Candidate for Unicompartmental Knee Replacement at a Chinese Arthroplasty Center?

Contact Info

Product

Resources

About