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Article: Subchondral bone expansion in advanced knee osteoarthritis: Relation with radiographic severity and role in surgical decision-making

TitleSubchondral bone expansion in advanced knee osteoarthritis: Relation with radiographic severity and role in surgical decision-making
Authors
KeywordsComputed tomography
Joint space narrowing
Knee osteoarthritis
Subchondral bone
Surgical decision-making
Issue Date1-Jun-2024
PublisherElsevier
Citation
Osteoarthritis and Cartilage Open, 2024, v. 6, n. 2 How to Cite?
AbstractBackground: Joint space width (JSW) is a traditional imaging marker for knee osteoarthritis (OA) severity, but it lacks sensitivity in advanced cases. We propose tibial subchondral bone area (TSBA), a new CT imaging marker to explore its relationship with OA radiographic severity, and to test its performance for classifying surgical decisions between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) compared to JSW. Methods: We collected clinical, radiograph, and CT data from 182 patients who underwent primary knee arthroplasty (73 UKA, 109 TKA). The radiographic severity was scored using Kellgren-Lawrence (KL) grading system. TSBA and JSW were extracted from 3D CT-reconstruction model. We used independent t-test to investigate the relationship between TSBA and KL grade, and binary logistic regression to identify factors associated with TKA risk. The accuracy of TSBA, JSW and established classification model in differentiating between UKA and TKA was assessed using AUC. Results: All parameters exhibited inter- and intra-class coefficients greater than 0.966. Patients with KL grade 4 had significantly larger TSBA than those with KL grade 3. TSBA (0.708 of AUC) was superior to minimal/average JSW (0.547/0.554 of AUC) associated with the risk of receiving TKA. Medial TSBA, together with gender and Knee Society Knee Score, emerged as independent classification factors in multivariate analysis. The overall AUC of composite model for surgical decision-making was 0.822. Conclusion: Tibial subchondral bone area is an independent imaging marker for radiographic severity, and is superior to JSW for surgical decision-making between UKA and TKA in advanced OA patients.
Persistent Identifierhttp://hdl.handle.net/10722/346479

 

DC FieldValueLanguage
dc.contributor.authorWang, Wei-
dc.contributor.authorJiang, Tianshu-
dc.contributor.authorZhang, Jiang-
dc.contributor.authorLiu, Jun-
dc.contributor.authorChan, Lok Chun-
dc.contributor.authorLin, Mengqi-
dc.contributor.authorLi, Jia-
dc.contributor.authorDing, Changhai-
dc.contributor.authorChiu, Kwong Yuen-
dc.contributor.authorFu, Henry-
dc.contributor.authorChan, Ping Keung-
dc.contributor.authorWen, Chunyi-
dc.date.accessioned2024-09-17T00:30:52Z-
dc.date.available2024-09-17T00:30:52Z-
dc.date.issued2024-06-01-
dc.identifier.citationOsteoarthritis and Cartilage Open, 2024, v. 6, n. 2-
dc.identifier.urihttp://hdl.handle.net/10722/346479-
dc.description.abstractBackground: Joint space width (JSW) is a traditional imaging marker for knee osteoarthritis (OA) severity, but it lacks sensitivity in advanced cases. We propose tibial subchondral bone area (TSBA), a new CT imaging marker to explore its relationship with OA radiographic severity, and to test its performance for classifying surgical decisions between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) compared to JSW. Methods: We collected clinical, radiograph, and CT data from 182 patients who underwent primary knee arthroplasty (73 UKA, 109 TKA). The radiographic severity was scored using Kellgren-Lawrence (KL) grading system. TSBA and JSW were extracted from 3D CT-reconstruction model. We used independent t-test to investigate the relationship between TSBA and KL grade, and binary logistic regression to identify factors associated with TKA risk. The accuracy of TSBA, JSW and established classification model in differentiating between UKA and TKA was assessed using AUC. Results: All parameters exhibited inter- and intra-class coefficients greater than 0.966. Patients with KL grade 4 had significantly larger TSBA than those with KL grade 3. TSBA (0.708 of AUC) was superior to minimal/average JSW (0.547/0.554 of AUC) associated with the risk of receiving TKA. Medial TSBA, together with gender and Knee Society Knee Score, emerged as independent classification factors in multivariate analysis. The overall AUC of composite model for surgical decision-making was 0.822. Conclusion: Tibial subchondral bone area is an independent imaging marker for radiographic severity, and is superior to JSW for surgical decision-making between UKA and TKA in advanced OA patients.-
dc.languageeng-
dc.publisherElsevier-
dc.relation.ispartofOsteoarthritis and Cartilage Open-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectComputed tomography-
dc.subjectJoint space narrowing-
dc.subjectKnee osteoarthritis-
dc.subjectSubchondral bone-
dc.subjectSurgical decision-making-
dc.titleSubchondral bone expansion in advanced knee osteoarthritis: Relation with radiographic severity and role in surgical decision-making-
dc.typeArticle-
dc.identifier.doi10.1016/j.ocarto.2024.100461-
dc.identifier.scopuseid_2-s2.0-85188543962-
dc.identifier.volume6-
dc.identifier.issue2-
dc.identifier.eissn2665-9131-
dc.identifier.issnl2665-9131-

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