Abstract
The purpose of this study was to assess the effectiveness of the ultrasonography (US) on detecting osteoarthritis of the knee, and compare US and radiographic findings to intraoperative total knee arthroplasty (TKA) findings. Fifty-seven late-stage osteoarthritic knees undergoing TKA were evaluated with US and radiography. Standard knee US assessing femoral cartilage damage, osteophytes, effusion, synovitis, and meniscal extrusion was performed. On radiographs, osteophytes, joint space narrowing, and Kellgren-Lawrence grade were evaluated. Corresponding intra-operative findings were assessed during TKA as the gold standard. On the damage of the medial femoral condyle cartilage, the sensitivity of US was high (92%), whereas on the lateral condyle and sulcus area, sensitivities were 58% and 46%, respectively. On osteophytes, the detection rate of the US was remarkable especially on the medial side yielding sensitivities of 90–95%. The sensitivities for detecting effusion and synovitis were also excellent (97%). US detection rate of femoral cartilage damage was in concordance with the radiographic joint space narrowing. For the detection of osteophytes, US provided superior results to radiography particularly on the medial side. In conclusion, US can reliably assess the late-stage OA changes of the knee especially on the medial side of the knee joint.
Highlights
The prevalence of osteoarthritis (OA) is soaring worldwide with increased age and obesity; currently, the global prevalence is estimated to be 5%1
The diagnostic performance of US on detecting osteoarthritic changes has been compared with magnetic resonance imaging (MRI) and arthroscopy[16,17]: Podlipska et al reported that osteophytes, cartilage changes in the medial femoral condyle and medial meniscal extrusion can be reliably assessed by US as compared to MRI findings[16]
Late-stage OA was defined as eligibility for total knee arthroplasty (TKA) i.e. a combination of typical clinical history and findings for knee OA supplemented with knee radiographs
Summary
The prevalence of osteoarthritis (OA) is soaring worldwide with increased age and obesity; currently, the global prevalence is estimated to be 5%1. As the radiography offers information preferably on the bone structures, US can be applied to assess the effusion, synovitis, osteophytes, menisci and the femoral cartilage of the knee joint. It has been shown that US detects osteophytes more readily than radiographs and that the cartilage defects of the medial femoral condyle correlate well with joint-space narrowing seen on radiographs[5,6,7,8]. The diagnostic performance of US on detecting osteoarthritic changes has been compared with magnetic resonance imaging (MRI) and arthroscopy[16,17]: Podlipska et al reported that osteophytes, cartilage changes in the medial femoral condyle and medial meniscal extrusion can be reliably assessed by US as compared to MRI findings[16]. The purpose of this study was to assess US findings on patients with late-stage knee OA undergoing total knee arthroplasty (TKA) and compare US findings with radiographic and intra-operative findings
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