Purpose: To assess whether magnetic resonance (MR) imaging-based cross-sectional measures of structural joint damage can be used to predict knee replacement during the following year.
Materials And Methods: Participants were drawn from the Osteoarthritis Initiative, a longitudinal observational study that includes 4796 participants who have knee osteoarthritis or are at risk. The HIPAA-compliant protocol was approved by the institutional review boards of all participating centers, and written informed consent was obtained from all participants. During the 5 years of follow-up, 199 knees underwent knee replacement and were matched with 199 control knees that did not undergo knee replacement. Knees were matched according to radiographic disease stage and patient sex and age. All knees that underwent knee replacement and had MR images available from the year before surgery were included. MR images were assessed for cartilage damage, bone marrow lesions, meniscal damage, meniscal extrusion, synovitis, and effusion prior to reported knee replacement. Conditional logistic regression was applied to assess the risk of knee replacement. Analyses were performed on a compartmental and knee level.
Results: Participants had a mean age ± standard deviation of 64.2 years ± 8.4 (range, 47-82 years) and were predominantly women (232 of 398 participants, 58.3%). Risk for knee replacement was significantly increased for knees that exhibited two or more subregions with severe cartilage loss (odds ratio [OR], 16.5; 95% confidence interval [CI]: 3.96, 68.76), more than two subregions with bone marrow lesions (OR, 4.00; 95% CI: 1.75, 9.16), medial meniscal maceration (OR, 1.84; 95% CI: 1.13, 2.99), effusion (OR, 4.75; 95% CI: 2.55, 8.85), or synovitis (OR, 2.17; 95% CI: 1.33, 3.56), but not extrusion (OR, 1.00; 95% CI: 0.60,1.67), when compared with knees that did not exhibit these features as the reference standard.
Conclusion: Apart from meniscal extrusion, all features of tissue abnormalities at MR imaging were related to clinical prognosis and could be used to predict knee replacement in the following year.
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http://dx.doi.org/10.1148/radiol.14140991 | DOI Listing |
Introduction Total knee arthroplasty (TKA) is a widely accepted surgical intervention for patients with advanced knee osteoarthritis, aimed at reducing pain and improving functional mobility. Preoperative radiological evaluations, including assessments of joint space narrowing, osteophytes, varus/valgus deformities, and subchondral sclerosis, are essential for planning the surgery and predicting postoperative outcomes. Although extensive research has been conducted internationally, data focusing on populations in Saudi Arabia remain limited.
View Article and Find Full Text PDFBMC Musculoskelet Disord
January 2025
VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, 450 Broadway Street MC: 6342, Redwood City, CA, 94603, USA.
Background: As value-based care arrangements continue to assess quality of care and costs, comprehensive and patient-centered definitions of quality of care are required. While patient-reported outcome measures are increasingly integrated into quality assessments following total joint arthroplasty (TJA), patient perceptions of quality paired with the phase of surgical care has not been described. The purpose of this study was to assess how TJA patients perceive measures of quality of care and assess if these perceptions change based on the phase of care.
View Article and Find Full Text PDFOrthop Traumatol Surg Res
January 2025
Centre hospitalier universitaire de Nancy, Hôpital central, Service de chirurgie orthopédique, traumatologique et arthroscopique, 29 avenue du Maréchal de Lattre de Tassigny, 54000, Nancy, France.
Introduction: Primary total knee arthroplasty (TKA) has shown excellent results in the treatment of osteoarthritis, and its indications have now been extended to younger patients of working age. Few articles in the literature have studied the return to work of young subjects, and no specific studies have been conducted in France. Therefore, we carried out a retrospective study to 1) investigate the rate and delay of return to work after primary TKA in a population under 55 years of age and 2) identify factors influencing early return to work before 3 months, the period usually used as the duration of initial work stoppage (TS).
View Article and Find Full Text PDFActa Orthop
January 2025
Department of Orthopaedics, Spaarne Gasthuis, Hoofddorp; Department of Oral Cell Biology, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Background And Purpose: Early migration of the uncemented cruciate-sacrificing rotating platform ATTUNE and Low Contact Stress (LCS) tibial components was classified as at-risk for aseptic loosening rates exceeding 6.5% at 15 years based on recent fixation-specific migration thresholds. In this secondary report of a randomized controlled trial (RCT) we aimed to evaluate whether the 5-year migration, inducible displacement, and the clinical outcome of the ATTUNE components were comparable to those of the LCS.
View Article and Find Full Text PDFActa Orthop
January 2025
Department of Surgery, Lovisenberg Diaconal Hospital, Oslo; Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
Background And Purpose: Measuring patient satisfaction after total hip (THA) and total knee arthroplasty (TKA) is important. We aimed to cross-culturally adapt and examine the psychometric properties of the self-reported Goodman Satisfaction Score (GSS) in a sample of Norwegian patients following primary THA and TKA.
Methods: The GSS was translated and adapted into Norwegian (GSS-NO) following standard guidelines.
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