Knee Joint Space Research Articles

Higher bone turnover detected by serum levels of tartrate-resistant acid phosphatase 5b (TRACP-5b) is a risk for the radiographic medial knee joint space narrowing in men in early forties without knee pain the three years prospective observational study

Higher bone turnover detected by serum levels of tartrate-resistant acid phosphatase 5b (TRACP-5b) is a risk for the radiographic medial knee joint space narrowing in men in early forties without knee pain the three years prospective observational study

Clinical predictors of medial knee osteoarthritis progression over 2 years

The overall aim of this study was to identify risk factors for knee osteoarthritis (OA) structural disease progression. More specifically, we aimed to identify what personal factors (age, sex, obesity, co-morbidity, Herberden’s nodes, history of injury, manual occupation and medication use), radiographic findings (Kellgren and Lawrence (K&L) grade, joint space width, alignment) and activity limitations (self-reported physical activity and physical function) independently predict medial knee joint space narrowing (JSN) over 2 years in people with painful medial knee OA.

A novel method for the assessment of knee joint space width and subchondral bone micro architecture

A novel method for the assessment of knee joint space width and subchondral bone micro architecture

Bone and joint modeling from 3D knee MRI: feasibility and comparison with radiographs and 2D MRI

PurposeThe purpose was to evaluate feasibility of bone and joint segmentations from three-dimensional magnetic resonance imaging (3D MRI). MethodsSegmented joint models from 3D MRI data set were obtained for 42 patients. Blinded angular and joint space measurements were performed on 3D MRI model, two-dimensional (2D) MRI, and radiography (XR). ResultsMedial joint space was similar on both XR and 3D MRI (P=.3). The XR measurements were statistically different but closer to 3D MRI for lateral patellar tilt angle, patellar tendon length, and lateral knee joint space, whereas 2D MRI measurements were closer to XR in terms of trochlear depth, sulcal angle, and patellar length. Conclusion3D bone and joint segmentations are feasible from isotropic MRI data sets.

Validity of radiographic assessment of the knee joint space using automatic image analysis

Objectives: The present study investigated whether there were differences between automatic and manual measurements of the minimum joint space width (mJSW) on knee radiographs.Methods: Knee radiographs of 324 participants in a systematic health screening were analyzed using the following three methods: manual measurement of film-based radiographs (Manual), manual measurement of digitized radiographs (Digital), and automatic measurement of digitized radiographs (Auto). The mean mJSWs on the medial and lateral sides of the knees were determined using each method, and measurement reliability was evaluated using intra-class correlation coefficients. Measurement errors were compared between normal knees and knees with radiographic osteoarthritis.Results: All three methods demonstrated good reliability, although the reliability was slightly lower with the Manual method than with the other methods. On the medial and lateral sides of the knees, the mJSWs were the largest in the Manual method and the smallest in the Auto method. The measurement errors of each method were significantly larger for normal knees than for radiographic osteoarthritis knees.Conclusions: The mJSW measurements are more accurate and reliable with the Auto method than with the Manual or Digital method, especially for normal knees. Therefore, the Auto method is ideal for the assessment of the knee joint space.

Relation between phalangeal bone mineral density and radiographic knee osteoarthritis: a cross-sectional study.

BackgroundMajor reports have suggested that bone mineral density (BMD) is higher in patients with osteoarthritis (OA), while other studies do not agree. Our aim was to examine the cross-sectional association between phalangeal BMD and radiographic knee OA.MethodsA total of 2855 participants were included in this study. Radiographic knee OA was defined as Kellgren-Lawrence (K-L) Grade ≥ 2 in at least one leg. BMD scans of the middle phalanges of the second, third and fourth digits of the nondominant hand were performed with a compact radiographic absorptiometry system (Alara MetriScan®). A multivariable logistic analysis model was applied to test the relation between phalangeal BMD with radiographic knee OA, the presence of knee osteophytes (OSTs), and knee joint space narrowing (JSN) after adjusting for a number of potential confounding factors.ResultsThe multivariable-adjusted odds ratios with 95 % confidence intervals [ORs (95 % CI)] of radiographic knee OA across phalangeal BMDs were 1.08 (95 % CI 0.89–1.32) and 0.62 (95 % CI 0.45–0.86), respectively. The P for trend was 0.09. For the female population, the multivariable-adjusted ORs (95 % CI) of radiographic knee OA across phalangeal BMD were 1.01 (95 % CI 0.73–1.37) and 0.58 (95 % CI 0.38 − 0.87), respectively. The P for trend was 0.02. This positive finding, however, did not exist in the male subgroup. There was a significantly lower prevalence of OST in the osteoporosis (OP) group than in the normal group (OR = 0.59, 95 % CI 0.40–0.88; P for trend was 0.01). In contrast, the prevalence of JSN was significantly higher in the osteopenia group (OR = 1.22, 95 % CI 1.00–1.48) and the OP group (OR = 1.35, 95 % CI 1.00–1.84) than in the normal group. The P for trend was 0.02.ConclusionsThis study observed lower odds for the presence of radiographic knee OA and OST in OP patients than in normal subjects. The prevalence of JSN was higher in the osteopenia and OP groups than in normal subjects.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-0918-x) contains supplementary material, which is available to authorized users.

Change in knee structure and change in tibiofemoral joint space width: a five year longitudinal population–based study

BackgroundChange in knee cartilage volume is frequently used as a proxy for change in knee joint space width over time, but longitudinal data on these associations is limited. We aimed to determine whether change in knee cartilage volume, new or worsening meniscal extrusion (ME), meniscal tears and cartilage defects over 2.4 years correlated with change in joint space width (JSW) over 5 years in older community dwelling adults.MethodsParticipants (n = 153) had their right knee imaged using MR imaging and x-ray at baseline, and after 2.4 years (MRI) and 5 years (x-ray). Cartilage volume, cartilage defects, meniscal extrusions and meniscal tears were assessed on sagittal T1-weighted fat-suppressed MRI. JSW was assessed using standard fixed semi-flexed view radiographs, and scored on those with adequate alignment.ResultsParticipants were 51–79 (mean 62) years old; 48 % were female. Cartilage volume reduced over time (medial −134 ± 202 μL/year, lateral −106 ± 165 μL/year, p < 0.001), as did JSW (medial −0.05 ± 0.16 mm/year, lateral −0.12 ± 0.24 mm/year, p < 0.001). In multivariable analysis, the only consistent predictor of change in JSW was new or worsening ME (medial tibia R2 3.1 %, p = 0.031; medial femur R2 3.2 %, p = 0.024); change in cartilage volume correlated with change in JSW laterally (R2 4.8 %, p = 0.007) and was borderline medially (R2 2.2 %, p = 0.064); there was no association for meniscal tears or cartilage defects. The magnitude of these associations were similar albeit somewhat greater for ME in participants with radiographic OA (R2 6.2 %, p = 0.017).ConclusionChange in ME and cartilage volume weakly predict change in JSW, but the vast majority of the variation remains unexplained. Since MRI examines cartilage directly while radiographs examine it indirectly, these results cast doubt on the validity of using JSW as a proxy measure of cartilage loss.

Cartilage Metabolic Status for the Radiographic Medial Knee Joint Space Narrowing in Men in Early Forties Without Knee Pain

Cartilage Metabolic Status for the Radiographic Medial Knee Joint Space Narrowing in Men in Early Forties Without Knee Pain

Increased 18F-FDG uptake suggests synovial inflammatory reaction with osteoarthritis: preliminary in-vivo results in humans.

The aim of this prospective study was to compare the metabolic activity of the knee joints of a group of patients with painful knees clinically (such as recurrent joint pain, joint instability, and functional limitations) consistent with osteoarthritis and those of another group of patients without such complaints, using [F]-2-fluoro-2-deoxy-D-glucose (F-FDG)-PET imaging. A total of 97 patients who participated in either painful joint prosthesis or diabetic foot research studies involving F-FDG-PET scans were asked to complete a knee pain questionnaire. The patients were asked whether they experienced pain in any joint, and if so, which joints were affected. A total of 18 knee joints without prosthesis were reported to be painful. The maximum standardized uptake values (SUVmax) of the middle joint space and lateral synovial tissue of these 18 knees were measured and compared with those of a set of patients with control asymptomatic knees. The average SUVmax of the middle part of the joint space in the painful knees was 1.35±0.59 compared with an average SUVmax value of 0.86±0.14 in the control group (P=0.0176). The average SUVmax of the synovium in the lateral part of the painful joints was 1.17±0.49 compared with 0.73±0.31 in the control group (P=0.0161). These data indicate that increased F-FDG uptake is associated with knee pain in osteoarthritis patients and that there is a positive relationship between the two parameters.

Accuracy and Reproducibility of Radiographic Knee Joint Space Narrowing Measurements Referenced to the Mid-Coronal Plane

Accuracy and Reproducibility of Radiographic Knee Joint Space Narrowing Measurements Referenced to the Mid-Coronal Plane

The relationships between bone mineral density and radiographic features of hand or knee osteoarthritis in older adults: data from the Dong-gu Study.

The relationship between OA and osteoporosis has exhibited contradictory features over the past four decades. The aim of this study was to determine using separate analysis of the radiographic features of OA whether various radiographic features of OA were associated differently with BMD in the Korean elderly. Data were derived from the Dong-gu cohort; 2354 subjects were enrolled in the present cross-sectional study. Baseline characteristics, the BMDs of the lumbar spine and femoral neck measured by DXA, and X-rays of knees and hands were collected. A semi-quantitative grading system was used to estimate the severities of individual radiographic features. We adjusted for confounders using multiple linear regression modelling to analyse the relationships. After adjustment for confounders, hand and knee OA total scores were negatively associated with the BMDs of the lumbar spine and femoral neck, except for the total knee OA score and lumbar spine BMD. In detail, hand osteophytes and sclerosis exhibited positive relationships with the BMDs of the lumbar spine and femoral neck, except for hand osteophytes and femoral neck BMD. On the contrary, however, knee joint space narrowing (JSN), hand JSN, and hand subchondral cysts were negatively associated with the BMD of the lumbar spine and femoral neck. Knee JSN and hand subchondral cysts exerted the greatest effects on BMD. Separate analysis of the radiographic features of OA better reveals associations of OA with the BMD of the lumbar spine and femoral neck.

25-Hydroxyvitamin D and osteoarthritis: A meta-analysis including new data.

To study the relationship between 25-hydroxy (OH) vitamin D serum levels and osteoarthritis (OA) of the knee, hip, and hand in a meta-analysis, with updated and expanded results of our previous study. Pubmed was searched from February 1975 to December 2014 for articles assessing the relationship between vitamin D levels and OA. In our meta-analysis, 6 cross-sectional and 6 longitudinal studies were included. The number of subjects in these studies ranged from 99 to 1248 subjects. The latter 1248 subjects (58% women) were drawn from the Rotterdam Study, a prospective population-based cohort study of the elderly. At baseline, 25(OH) vitamin D serum levels were measured and prevalent OA of knees, hips and hands was scored by the Kellgren-Lawrence grading system. After a mean follow-up time was 8.4 years, incidence and progression of OA were assessed. No clear association between vitamin serum levels and prevalent, incident or progressive knee, hip or hand OA was observed. The quality of most studies was low, and the results were conflicting. Meta-analysis of 3 cross-sectional studies on vitamin D levels and knee joint space narrowing (JSN) showed an increased risk of prevalent JSN with decreasing vitamin D levels (OR = 1.52, 95% CI: 1.15-2.01). The association observed in the meta-analysis of 3 studies on low vitamin D levels and incident and progressive knee OA was not significant (OR = 1.37, 95% CI: 0.97-1.92); however, when considering solely progressive knee OA, the risk was significantly increased (OR = 2.40, 95% CI: 1.22-4.72). Epidemiological studies do not provide evidence of an independent association between 25(OH) vitamin D serum levels with hip or hand OA. When analyzing subgroups of knee OA, significant associations of low vitamin D levels with prevalent knee JSN and with progressive knee OA were observed. Overall, the results of this study do not support the advice to supplement vitamin D to prevent the onset or worsening of osteoarthritis, except perhaps for progressive knee OA.

Association Between Infrapatellar Fat Pad Volume and Knee Structural Changes in Patients with Knee Osteoarthritis.

The function of the infrapatellar fat pad (IPFP) in knee osteoarthritis (OA) remains uncertain. This study aimed to examine cross-sectional associations between IPFP volume and knee structures in patients with knee OA. The study included 174 patients with clinical knee OA (mean age, 55.5 yrs). Fat-suppressed 3-D T1-weighted spoiled gradient recall magnetic resonance imaging (MRI) was used to measure the IPFP and cartilage volume. T2-weighted fast spin echo MRI was used to assess cartilage defects and bone marrow lesions (BML). Radiographic knee osteophytes and joint space narrowing (JSN) were assessed using the Osteoarthritis Research Society International atlas. After adjustment for potential confounders, greater IPFP volume was associated with greater tibial and patellar cartilage volume (all p < 0.05), and fewer cartilage defects at all sites (OR 0.88-0.91, all p < 0.05). IPFP volume was associated with presence of BML at lateral tibial and medial femoral sites (OR 0.88-0.91, all p < 0.05) and osteophytes at lateral tibiofemoral compartment (OR 0.88, p < 0.05). IPFP volume was not significantly associated with JSN. Greater IPFP volume was associated with greater knee cartilage volume and fewer structural abnormalities, suggesting a protective role of IPFP size in knee OA.

A Cystic Mass in the Popliteal Fossa and Its Differential Diagnosis.

A Cystic Mass in the Popliteal Fossa and Its Differential Diagnosis.

Identification of a novel target, FoxA2, in the onset and development of osteoarthritis

Identification of a novel target, FoxA2, in the onset and development of osteoarthritis

The lower cartilage synthesis, but not higher cartilage destruction, is associated with the knee joint space width in men in early forties without knee pain

The lower cartilage synthesis, but not higher cartilage destruction, is associated with the knee joint space width in men in early forties without knee pain

Method and effect of total knee arthroplasty osteotomy and soft tissue release for serious knee joint space narrowing.

To discuss the method and effect of total knee arthroplasty osteotomy and soft tissue release for serious knee joint space narrowing. Clinical data of 80 patients from October 2013 to December 2014 was selected with a retrospective method. All patients have undergone total knee arthroplasty. Then the X-rays plain film in weight loading was measured before and after operation and osteotomy was performed accurately according to the knee joint scores and the conditions of lower limb alignments. The average angle of tibial plateau osteotomy of postoperative patients was 4.3°, and the corrective angle of soft tissue balancing was 10.7°; the postoperative patients’ indicies including range of joint motion, knee joint HSS score, angle between articular surfaces, tibial angle, femoral-tibial angle and flexion contracture were distinctly better than the preoperative indicies (p<0.05) and the differences were statistically significant; the postoperative patients’ flexion contracture and range of joint motion were distinctly better than the preoperative indicies (p<0.05) and the differences were statistically significant. The effective release of the soft tissue of the posterior joint capsule under direct vision can avoid excess osteotomy and get satisfactory knee replacement space without influencing the patients’ joint recovery.

Giant Loose Body of Knee Joint Presenting as Accessory Patella&amp;lt;br/&amp;gt;—A Case Report

Loose bodies are freely floating fragments of cartilage or bone inside the knee joint space. This is commonly seen in association with degenerative joint disease (DJD), direct or indirect trauma, synovial chondromatosis, osteochondritis dissecans (OCD) and size of the loose body may vary from few millimeters to few centimeters. Patients with loose bodies in knee joint presented to orthopaedists with knee pain, swelling and restricted movement, with intermittent locking or catching of the joint. This is managed surgically most of the times when it becomes symptomatic. The surgical technique most commonly utilized is arthroscopy. Open arthrotomy should be done when the loose bodies are very large/numerous/located in posterior joint space. In review of literature, we found very few cases of giant loose body in knee joint due to DJD reported in last 70 years. We are hereby reporting our case of 60-year-old male with a giant loose body of same size as of patella in the supra-patellar pouch of left knee joint and managed by arthrotomy to remove the giant loose body. Post-operatively patient recovered significantly over the period of 6-week follow-up. In conclusion, giant loose body should be removed through arthrotomy and all such cases should be thoroughly evaluated to diagnose the cause of giant loose body.

Role of Footwear Alteration along with Conventional Physiotherapy in Osteoarthritis Knee

Inspite of vast array of conservative treatment interventions for medial knee osteoarthritis, their effectiveness in its management is still contentious. Numerous researchers have suggested the role of footwear modification in reducing medial knee joint space load and hence reducing pain and improving functional status. However, most of the studies were cross-sectional in nature and have not seen the alteration in compendium of factors like radiographic changes, static alignment, kinesiological factors, gait parameters and most importantly plantar pressure distribution following 6 months of footwear modification along with conservative physiotherapy. The results of the present study suggested that footwear alteration along with conventional physiotherapy was effective not only in improving clinical outcomes but also increasing medial knee joint space width, changing static alignment, improving kinesiological factors, gait parameters and plantar pressure distribution in patients of osteoarthritis knee.

OP0063 Associations between Abnormal Infrapatellar FAT PAD Quality and Knee Osteoarthritic Changes in Older Adults: A Cohort Study

BackgroundInfrapatellar fat pad (IPFP), an intracapsular but extrasynovial structure, is situated in the knee under the patella, between the patellar tendon, femoral condyle and tibial plateau, and is structurally similar...