The Experts below are selected from a list of 3612 Experts worldwide ranked by ideXlab platform
M.-p. Hellio Le Graverand - One of the best experts on this subject based on the ideXlab platform.
-
in normal knees joint space width jsw is correlated with the intermargin distance imd a measure of Medial Tibial Plateau alignment variations in imd explain variability in jsw in serial radiographs
Joint Bone Spine, 2013Co-Authors: Catherine Mercier, Kenneth D Brandt, Eric Vignon, Marc C. Hochberg, M Piperno, M.-p. Hellio Le GraverandAbstract:Abstract Objective To ascertain the importance of alignment of the Medial Tibial Plateau (MTP), as determined by the distance between the anterior and posterior margins of the Plateau (intermargin distance [IMD]), for measurements of joint space width (JSW) in radiographs of normal knees. Methods JSW and IMD were measured in paired baseline and 12-month knee films of 122 subjects from the osteoarthritis initiative (OAI). Relationships between JSW and IMD, and between the variation in JSW and variation in IMD, were evaluated. Results In cross-sectional analysis, a non-linear relationship existed between JSW and the concurrent IMD. With poor MTP alignment (IMD > 1.7 mm), a 1.0-mm increase in IMD resulted in a 0.16-mm (95%CI: 0.11–0.21) increase in JSW ( P P Baseline and IMD 12month was associated with a 0.10-mm (95% CI: 0.06–0.13) variation in JSW, with variations in JSW and IMD occurring in the same direction. An IMD variation less than or equal to 1.0 mm was determined to be acceptable for accurate evaluation of JSW in serial radiographs. Conclusion The error in measurement of JSW caused by variation in IMD in serial radiographs of normal knees can be as large, or larger, than the mean rate of 12-month joint space narrowing (JSN) in OA knees. MTP alignment and replication of alignment in serial knee films are required for accurate determination of JSN in OA knee.
-
In normal knees, joint space width (JSW) is correlated with the intermargin distance (IMD), a measure of Medial Tibial Plateau alignment. Variations in IMD explain variability in JSW in serial radiographs.
Joint bone spine, 2012Co-Authors: Catherine Mercier, Kenneth D Brandt, Eric Vignon, Marc C. Hochberg, M Piperno, M.-p. Hellio Le GraverandAbstract:To ascertain the importance of alignment of the Medial Tibial Plateau (MTP), as determined by the distance between the anterior and posterior margins of the Plateau (intermargin distance [IMD]), for measurements of joint space width (JSW) in radiographs of normal knees. JSW and IMD were measured in paired baseline and 12-month knee films of 122 subjects from the osteoarthritis initiative (OAI). Relationships between JSW and IMD, and between the variation in JSW and variation in IMD, were evaluated. In cross-sectional analysis, a non-linear relationship existed between JSW and the concurrent IMD. With poor MTP alignment (IMD>1.7 mm), a 1.0-mm increase in IMD resulted in a 0.16-mm (95%CI: 0.11-0.21) increase in JSW (P<0.0001). In a longitudinal analysis, the effect of IMD variation on variation in JSW was also highly significant (P<0.0001). A variation of 1 mm between IMD(Baseline) and IMD(12month) was associated with a 0.10-mm (95% CI: 0.06-0.13) variation in JSW, with variations in JSW and IMD occurring in the same direction. An IMD variation less than or equal to 1.0mm was determined to be acceptable for accurate evaluation of JSW in serial radiographs. The error in measurement of JSW caused by variation in IMD in serial radiographs of normal knees can be as large, or larger, than the mean rate of 12-month joint space narrowing (JSN) in OA knees. MTP alignment and replication of alignment in serial knee films are required for accurate determination of JSN in OA knee. Copyright © 2012. Published by Elsevier SAS.
-
effect of Medial Tibial Plateau alignment on serial radiographs on the capacity to predict progression of knee osteoarthritis
Osteoarthritis and Cartilage, 2008Co-Authors: S Bothascheepers, Maxime Dougados, Philippe Ravaud, M.-p. Hellio Le Graverand, Iain Watt, Ferdinand C. Breedveld, Margreet KloppenburgAbstract:Summary Objective To evaluate the effect of Medial Tibial Plateau (MTP) alignment of serial radiographs on the capacity to detect associations between baseline characteristics and progression of joint space narrowing (JSN) in knee osteoarthritis (OA). Methods Standardised posteroanterior weight-bearing knee radiographs of 83 knee OA patients were obtained at baseline and after 24 months using the non-fluoroscopic fixed-flexion protocol. Minimum joint space width (JSW) of the Medial tibiofemoral joint spaces was measured manually in paired radiographs. Progression of JSN was defined by a change in JSW larger than the smallest detectable difference (0.4mm). Satisfactory MTP alignment was present if the distance between the anterior and posterior margins of the MTP was ≤1mm. Standardised questionnaires were used to record age, sex and body mass index. Medial tibiofemoral JSN and osteophyte severity at baseline were graded with the Osteoarthritis Research Society International (OARSI) atlas. Results Progression of JSN was observed in 31 (28.4%) of 109 OA knees. In the sub sample of 48 (44%) OA knees with satisfactory MTP alignment on baseline and 24-month radiographs, 18 (37.5%) knees progressed. Stronger (statistically significant) associations were found between sex, generalised OA, JSN and osteophyte severity at baseline and progression of JSN in the sub sample of radiographs with serial satisfactorily MTP alignment than in all radiographs together. Conclusion Insufficient quality of MTP alignment on serial radiographs could prevent detection of associations between baseline characteristics and progression of JSN in knee OA. These findings may have implications for longitudinal knee OA studies using the fixed-flexion protocol.
-
Effect of Medial Tibial Plateau alignment on serial radiographs on the capacity to predict progression of knee osteoarthritis.
Osteoarthritis and cartilage, 2008Co-Authors: S. Botha-scheepers, Maxime Dougados, Philippe Ravaud, M.-p. Hellio Le Graverand, Iain Watt, Ferdinand C. Breedveld, Margreet KloppenburgAbstract:To evaluate the effect of Medial Tibial Plateau (MTP) alignment of serial radiographs on the capacity to detect associations between baseline characteristics and progression of joint space narrowing (JSN) in knee osteoarthritis (OA). Standardised posteroanterior weight-bearing knee radiographs of 83 knee OA patients were obtained at baseline and after 24 months using the non-fluoroscopic fixed-flexion protocol. Minimum joint space width (JSW) of the Medial tibiofemoral joint spaces was measured manually in paired radiographs. Progression of JSN was defined by a change in JSW larger than the smallest detectable difference (0.4mm). Satisfactory MTP alignment was present if the distance between the anterior and posterior margins of the MTP was < or = 1mm. Standardised questionnaires were used to record age, sex and body mass index. Medial tibiofemoral JSN and osteophyte severity at baseline were graded with the Osteoarthritis Research Society International (OARSI) atlas. Progression of JSN was observed in 31 (28.4%) of 109 OA knees. In the sub sample of 48 (44%) OA knees with satisfactory MTP alignment on baseline and 24-month radiographs, 18 (37.5%) knees progressed. Stronger (statistically significant) associations were found between sex, generalised OA, JSN and osteophyte severity at baseline and progression of JSN in the sub sample of radiographs with serial satisfactorily MTP alignment than in all radiographs together. Insufficient quality of MTP alignment on serial radiographs could prevent detection of associations between baseline characteristics and progression of JSN in knee OA. These findings may have implications for longitudinal knee OA studies using the fixed-flexion protocol.
Kenneth D Brandt - One of the best experts on this subject based on the ideXlab platform.
-
in normal knees joint space width jsw is correlated with the intermargin distance imd a measure of Medial Tibial Plateau alignment variations in imd explain variability in jsw in serial radiographs
Joint Bone Spine, 2013Co-Authors: Catherine Mercier, Kenneth D Brandt, Eric Vignon, Marc C. Hochberg, M Piperno, M.-p. Hellio Le GraverandAbstract:Abstract Objective To ascertain the importance of alignment of the Medial Tibial Plateau (MTP), as determined by the distance between the anterior and posterior margins of the Plateau (intermargin distance [IMD]), for measurements of joint space width (JSW) in radiographs of normal knees. Methods JSW and IMD were measured in paired baseline and 12-month knee films of 122 subjects from the osteoarthritis initiative (OAI). Relationships between JSW and IMD, and between the variation in JSW and variation in IMD, were evaluated. Results In cross-sectional analysis, a non-linear relationship existed between JSW and the concurrent IMD. With poor MTP alignment (IMD > 1.7 mm), a 1.0-mm increase in IMD resulted in a 0.16-mm (95%CI: 0.11–0.21) increase in JSW ( P P Baseline and IMD 12month was associated with a 0.10-mm (95% CI: 0.06–0.13) variation in JSW, with variations in JSW and IMD occurring in the same direction. An IMD variation less than or equal to 1.0 mm was determined to be acceptable for accurate evaluation of JSW in serial radiographs. Conclusion The error in measurement of JSW caused by variation in IMD in serial radiographs of normal knees can be as large, or larger, than the mean rate of 12-month joint space narrowing (JSN) in OA knees. MTP alignment and replication of alignment in serial knee films are required for accurate determination of JSN in OA knee.
-
In normal knees, joint space width (JSW) is correlated with the intermargin distance (IMD), a measure of Medial Tibial Plateau alignment. Variations in IMD explain variability in JSW in serial radiographs.
Joint bone spine, 2012Co-Authors: Catherine Mercier, Kenneth D Brandt, Eric Vignon, Marc C. Hochberg, M Piperno, M.-p. Hellio Le GraverandAbstract:To ascertain the importance of alignment of the Medial Tibial Plateau (MTP), as determined by the distance between the anterior and posterior margins of the Plateau (intermargin distance [IMD]), for measurements of joint space width (JSW) in radiographs of normal knees. JSW and IMD were measured in paired baseline and 12-month knee films of 122 subjects from the osteoarthritis initiative (OAI). Relationships between JSW and IMD, and between the variation in JSW and variation in IMD, were evaluated. In cross-sectional analysis, a non-linear relationship existed between JSW and the concurrent IMD. With poor MTP alignment (IMD>1.7 mm), a 1.0-mm increase in IMD resulted in a 0.16-mm (95%CI: 0.11-0.21) increase in JSW (P<0.0001). In a longitudinal analysis, the effect of IMD variation on variation in JSW was also highly significant (P<0.0001). A variation of 1 mm between IMD(Baseline) and IMD(12month) was associated with a 0.10-mm (95% CI: 0.06-0.13) variation in JSW, with variations in JSW and IMD occurring in the same direction. An IMD variation less than or equal to 1.0mm was determined to be acceptable for accurate evaluation of JSW in serial radiographs. The error in measurement of JSW caused by variation in IMD in serial radiographs of normal knees can be as large, or larger, than the mean rate of 12-month joint space narrowing (JSN) in OA knees. MTP alignment and replication of alignment in serial knee films are required for accurate determination of JSN in OA knee. Copyright © 2012. Published by Elsevier SAS.
-
Alignment of the Medial Tibial Plateau affects the rate of joint space narrowing in the osteoarthritic knee.
Osteoarthritis and cartilage, 2010Co-Authors: Eric Vignon, Kenneth D Brandt, Catherine Mercier, Marc C. Hochberg, David J. Hunter, S.a. Mazzuca, Kimerly A. Powell, B. Wyman, M.-p. Hellio Le GraverandAbstract:Summary Objective To determine, in serial fixed-flexion (FF) radiographs of subjects with knee osteoarthritis (KOA), the importance of, and basis for, the effect of alignment of the Medial Tibial Plateau (MTP), as determined by the inter-margin distance (IMD), on joint space narrowing (JSN). Methods Baseline and 12-month X-rays of 590 knees with Kellgren and Lawrence grade (KLG) 2/3 OA from the public-release dataset of the Osteoarthritis Initiative (OAI) were assigned to subgroups based upon IMD at baseline (IMD BL ) and the difference between IMD BL and IMD 12mos . Relationships of JSN to IMD BL and to the difference between IMD BL and IMD 12mos were evaluated. Results In all 590 knees, mean JSN was 0.13±0.51mm ( P BL in the 12-month film were, in general, poor. JSN was significantly ( P =0.012) more rapid in Subgroup A (IMD≤1.70mm at both time points) than in Subgroup B (both IMDs>1.70mm): 0.15±0.43; 0.08±0.47. Within Subgroup B we identified a subset, Subgroup B1, in which, although alignment was poor at both time points, the large IMD BL was, by chance, highly reproduced by IMD 12mos (difference between the two IMDs=0.01±0.27mm, NS). JSN in Subgroup B1 was 0.06±0.41mm and did not differ from that in other knees of Subgroup B ( P =0.87). The standardized response mean (SRM) in all 590 knees and Subgroups A, B and B1 was 0.25, 0.34, 0.17 and 0.06, respectively. Independent of IMD BL , JSN correlated significantly with the difference between the IMDs in the two radiographs ( r =0.17, P =0.0001). Conclusion Skewed MTP alignment in serial films and poor replication of IMD BL in the follow-up exam affect JSN measurement. The magnitude of change in joint space width (JSW) related to the poor quality of alignment that is common with the FF view jeopardizes accurate evaluation of JSN.
-
effect of alignment of the Medial Tibial Plateau and x ray beam on apparent progression of osteoarthritis in the standing anteroposterior knee radiograph
Arthritis & Rheumatism, 2001Co-Authors: Steven A Mazzuca, Kenneth D Brandt, Paul Dieppe, Michael Doherty, Barry P Katz, Kathleen A LaneAbstract:Objective Previous studies of knee osteoarthritis (OA) have yielded variable estimates of the rate of joint space narrowing (JSN) in the standing anteroposterior (AP) radiograph, due largely to longitudinal changes in the alignment of the Medial Tibial Plateau (MTP) and x-ray beam. To characterize this bias, we examined serial radiographs of subjects with knee OA in population-based and clinical OA cohorts from 3 locations in the United States and the United Kingdom. Methods Radiographic features of knee OA (e.g., osteophytosis, JSN) and MTP alignment in 428 OA knees were evaluated by consensus of 2 readers. Alignment was considered satisfactory if the anterior and posterior margins of the MTP were superimposed within 1 mm. Readers were blinded to subject identity, and films were read in random order. The minimum Medial joint space width was also measured manually (standard error of repeated measurements 0.20 mm) in serial knee images. Results Only 14% of serial radiographs exhibited alignment of the MTP in both images. In OA knees with satisfactory alignment in both images, the mean rate of JSN over 2–3 years (0.26 mm/year) was significantly larger (P = 0.004) than that in OA knees with misalignment in 1 or both radiographs and was 86% more rapid than the mean JSN in all OA knees. Moreover, the within-group standard deviation of JSN was significantly smaller among knees with reproduced alignment of the MTP than in knees in which misalignment occurred in 1 or both images (P = 0.006). Conclusion Poor standardization of knee positioning in serial standing AP radiographs in previous studies of OA progression has obscured the rate and variability of articular cartilage loss in subjects with knee OA. True JSN (i.e., JSN that is not attributable to longitudinal changes in the alignment of the MTP with the x-ray beam in serial radiographic examinations) may occur more rapidly, and with less between-subject variability, than that previously thought to be characteristic of knee OA.
Catherine Mercier - One of the best experts on this subject based on the ideXlab platform.
-
in normal knees joint space width jsw is correlated with the intermargin distance imd a measure of Medial Tibial Plateau alignment variations in imd explain variability in jsw in serial radiographs
Joint Bone Spine, 2013Co-Authors: Catherine Mercier, Kenneth D Brandt, Eric Vignon, Marc C. Hochberg, M Piperno, M.-p. Hellio Le GraverandAbstract:Abstract Objective To ascertain the importance of alignment of the Medial Tibial Plateau (MTP), as determined by the distance between the anterior and posterior margins of the Plateau (intermargin distance [IMD]), for measurements of joint space width (JSW) in radiographs of normal knees. Methods JSW and IMD were measured in paired baseline and 12-month knee films of 122 subjects from the osteoarthritis initiative (OAI). Relationships between JSW and IMD, and between the variation in JSW and variation in IMD, were evaluated. Results In cross-sectional analysis, a non-linear relationship existed between JSW and the concurrent IMD. With poor MTP alignment (IMD > 1.7 mm), a 1.0-mm increase in IMD resulted in a 0.16-mm (95%CI: 0.11–0.21) increase in JSW ( P P Baseline and IMD 12month was associated with a 0.10-mm (95% CI: 0.06–0.13) variation in JSW, with variations in JSW and IMD occurring in the same direction. An IMD variation less than or equal to 1.0 mm was determined to be acceptable for accurate evaluation of JSW in serial radiographs. Conclusion The error in measurement of JSW caused by variation in IMD in serial radiographs of normal knees can be as large, or larger, than the mean rate of 12-month joint space narrowing (JSN) in OA knees. MTP alignment and replication of alignment in serial knee films are required for accurate determination of JSN in OA knee.
-
In normal knees, joint space width (JSW) is correlated with the intermargin distance (IMD), a measure of Medial Tibial Plateau alignment. Variations in IMD explain variability in JSW in serial radiographs.
Joint bone spine, 2012Co-Authors: Catherine Mercier, Kenneth D Brandt, Eric Vignon, Marc C. Hochberg, M Piperno, M.-p. Hellio Le GraverandAbstract:To ascertain the importance of alignment of the Medial Tibial Plateau (MTP), as determined by the distance between the anterior and posterior margins of the Plateau (intermargin distance [IMD]), for measurements of joint space width (JSW) in radiographs of normal knees. JSW and IMD were measured in paired baseline and 12-month knee films of 122 subjects from the osteoarthritis initiative (OAI). Relationships between JSW and IMD, and between the variation in JSW and variation in IMD, were evaluated. In cross-sectional analysis, a non-linear relationship existed between JSW and the concurrent IMD. With poor MTP alignment (IMD>1.7 mm), a 1.0-mm increase in IMD resulted in a 0.16-mm (95%CI: 0.11-0.21) increase in JSW (P<0.0001). In a longitudinal analysis, the effect of IMD variation on variation in JSW was also highly significant (P<0.0001). A variation of 1 mm between IMD(Baseline) and IMD(12month) was associated with a 0.10-mm (95% CI: 0.06-0.13) variation in JSW, with variations in JSW and IMD occurring in the same direction. An IMD variation less than or equal to 1.0mm was determined to be acceptable for accurate evaluation of JSW in serial radiographs. The error in measurement of JSW caused by variation in IMD in serial radiographs of normal knees can be as large, or larger, than the mean rate of 12-month joint space narrowing (JSN) in OA knees. MTP alignment and replication of alignment in serial knee films are required for accurate determination of JSN in OA knee. Copyright © 2012. Published by Elsevier SAS.
-
Alignment of the Medial Tibial Plateau affects the rate of joint space narrowing in the osteoarthritic knee.
Osteoarthritis and cartilage, 2010Co-Authors: Eric Vignon, Kenneth D Brandt, Catherine Mercier, Marc C. Hochberg, David J. Hunter, S.a. Mazzuca, Kimerly A. Powell, B. Wyman, M.-p. Hellio Le GraverandAbstract:Summary Objective To determine, in serial fixed-flexion (FF) radiographs of subjects with knee osteoarthritis (KOA), the importance of, and basis for, the effect of alignment of the Medial Tibial Plateau (MTP), as determined by the inter-margin distance (IMD), on joint space narrowing (JSN). Methods Baseline and 12-month X-rays of 590 knees with Kellgren and Lawrence grade (KLG) 2/3 OA from the public-release dataset of the Osteoarthritis Initiative (OAI) were assigned to subgroups based upon IMD at baseline (IMD BL ) and the difference between IMD BL and IMD 12mos . Relationships of JSN to IMD BL and to the difference between IMD BL and IMD 12mos were evaluated. Results In all 590 knees, mean JSN was 0.13±0.51mm ( P BL in the 12-month film were, in general, poor. JSN was significantly ( P =0.012) more rapid in Subgroup A (IMD≤1.70mm at both time points) than in Subgroup B (both IMDs>1.70mm): 0.15±0.43; 0.08±0.47. Within Subgroup B we identified a subset, Subgroup B1, in which, although alignment was poor at both time points, the large IMD BL was, by chance, highly reproduced by IMD 12mos (difference between the two IMDs=0.01±0.27mm, NS). JSN in Subgroup B1 was 0.06±0.41mm and did not differ from that in other knees of Subgroup B ( P =0.87). The standardized response mean (SRM) in all 590 knees and Subgroups A, B and B1 was 0.25, 0.34, 0.17 and 0.06, respectively. Independent of IMD BL , JSN correlated significantly with the difference between the IMDs in the two radiographs ( r =0.17, P =0.0001). Conclusion Skewed MTP alignment in serial films and poor replication of IMD BL in the follow-up exam affect JSN measurement. The magnitude of change in joint space width (JSW) related to the poor quality of alignment that is common with the FF view jeopardizes accurate evaluation of JSN.
Koji Okamoto - One of the best experts on this subject based on the ideXlab platform.
-
Validation of the Macroscopic Anterior Cruciate Ligament Status Using the Oxford Classification System in Relation to Cartilage Defects on the Medial Tibial Plateau in Osteoarthritic Knees.
The journal of knee surgery, 2020Co-Authors: Takafumi Hiranaka, Yuichi Hida, Takaaki Fujishiro, Toshikazu Tanaka, Kenjiro Okimura, Koji OkamotoAbstract:This study evaluated the relationships between anterior cruciate ligament (ACL) grading using the Oxford classification system and cartilage defects on the Medial Tibial Plateau to clarify the validity of the system. We studied the location and size of a full-thickness cartilage defect of the Medial Tibial Plateau in 154 knees (97 patients) treated by unicompartmental (113) or total (41) knee arthroplasty between April 2017 and January 2018, and analyzed their relationship to the anterior cruciate ligament (ACL) grade, Grade 1 (normal), Grade 2 (synovial damage), Grade 3 (longitudinal split), Grade 4 (friable and fragmented), and Grade 5 (absent). Significant trends in decreased posterior preserved cartilage, increased defect length, and posteriorized defect center were associated with increasing ACL grade. Multiple comparison analysis revealed that the measurements were significantly different between ACL functional (Grades 1–3) and ACL deficient (Grades 4 and 5). On the other hand, the anterior preserved cartilage was consistent among the Grades. The macroscopic Oxford ACL classification system well described the disease progression where the cartilage defect extends posteriorly with ACL damage. However, 38% of ACL deficient knees had well-preserved posterior cartilage with no evident Tibial anterior translation.
-
unicompartmental knee arthroplasty for spontaneous osteonecrosis of the Medial Tibial Plateau
Knee, 2018Co-Authors: Tomoyuki Kamenaga, Takafumi Hiranaka, Yuichi Hida, Takaaki Fujishiro, Koji OkamotoAbstract:Abstract Background There have been very few reports on isolated Medial Tibial Plateau osteonecrosis, and the condition has not been clearly described. Unicompartmental knee arthroplasty (UKA) may be an appropriate treatment method for this condition. The aims of this study were to report our experience of using mobile-bearing knee implants for osteonecrosis of the Medial Tibial Plateau and to discuss the etiology and treatment of this type of osteonecrosis. Methods This study included six consecutive patients with isolated Medial Tibial Plateau osteonecrosis treated with an Oxford mobile-bearing knee implant. The average age was 71.0 years. We preoperatively graded the Tibial necrosis lesion using radiographic findings. We also assessed the area and size of necrosis, extent of the surrounding high-density area, and the presence of any meniscal lesions by preoperative magnetic resonance imaging (MRI), and pre- and postoperative Oxford Knee Scores (OKS) were evaluated. Results MRI findings revealed that all patients had meniscal lesions in addition to a necrotic lesion. All patients significantly improved in their OKS. No knees required revision for either infection or loosening. Conclusions The etiology of these cases of necrosis is still unclear, but the current study suggested an association with Medial meniscal lesions. The results of the study were promising, showing a good short-term clinical outcome of Oxford mobile-bearing UKA for this type of osteonecrosis.
-
Unicompartmental knee arthroplasty for spontaneous osteonecrosis of the Medial Tibial Plateau.
The Knee, 2018Co-Authors: Tomoyuki Kamenaga, Takafumi Hiranaka, Yuichi Hida, Takaaki Fujishiro, Koji OkamotoAbstract:There have been very few reports on isolated Medial Tibial Plateau osteonecrosis, and the condition has not been clearly described. Unicompartmental knee arthroplasty (UKA) may be an appropriate treatment method for this condition. The aims of this study were to report our experience of using mobile-bearing knee implants for osteonecrosis of the Medial Tibial Plateau and to discuss the etiology and treatment of this type of osteonecrosis. This study included six consecutive patients with isolated Medial Tibial Plateau osteonecrosis treated with an Oxford mobile-bearing knee implant. The average age was 71.0 years. We preoperatively graded the Tibial necrosis lesion using radiographic findings. We also assessed the area and size of necrosis, extent of the surrounding high-density area, and the presence of any meniscal lesions by preoperative magnetic resonance imaging (MRI), and pre- and postoperative Oxford Knee Scores (OKS) were evaluated. MRI findings revealed that all patients had meniscal lesions in addition to a necrotic lesion. All patients significantly improved in their OKS. No knees required revision for either infection or loosening. The etiology of these cases of necrosis is still unclear, but the current study suggested an association with Medial meniscal lesions. The results of the study were promising, showing a good short-term clinical outcome of Oxford mobile-bearing UKA for this type of osteonecrosis. Copyright © 2018 Elsevier B.V. All rights reserved.
Eric Vignon - One of the best experts on this subject based on the ideXlab platform.
-
in normal knees joint space width jsw is correlated with the intermargin distance imd a measure of Medial Tibial Plateau alignment variations in imd explain variability in jsw in serial radiographs
Joint Bone Spine, 2013Co-Authors: Catherine Mercier, Kenneth D Brandt, Eric Vignon, Marc C. Hochberg, M Piperno, M.-p. Hellio Le GraverandAbstract:Abstract Objective To ascertain the importance of alignment of the Medial Tibial Plateau (MTP), as determined by the distance between the anterior and posterior margins of the Plateau (intermargin distance [IMD]), for measurements of joint space width (JSW) in radiographs of normal knees. Methods JSW and IMD were measured in paired baseline and 12-month knee films of 122 subjects from the osteoarthritis initiative (OAI). Relationships between JSW and IMD, and between the variation in JSW and variation in IMD, were evaluated. Results In cross-sectional analysis, a non-linear relationship existed between JSW and the concurrent IMD. With poor MTP alignment (IMD > 1.7 mm), a 1.0-mm increase in IMD resulted in a 0.16-mm (95%CI: 0.11–0.21) increase in JSW ( P P Baseline and IMD 12month was associated with a 0.10-mm (95% CI: 0.06–0.13) variation in JSW, with variations in JSW and IMD occurring in the same direction. An IMD variation less than or equal to 1.0 mm was determined to be acceptable for accurate evaluation of JSW in serial radiographs. Conclusion The error in measurement of JSW caused by variation in IMD in serial radiographs of normal knees can be as large, or larger, than the mean rate of 12-month joint space narrowing (JSN) in OA knees. MTP alignment and replication of alignment in serial knee films are required for accurate determination of JSN in OA knee.
-
In normal knees, joint space width (JSW) is correlated with the intermargin distance (IMD), a measure of Medial Tibial Plateau alignment. Variations in IMD explain variability in JSW in serial radiographs.
Joint bone spine, 2012Co-Authors: Catherine Mercier, Kenneth D Brandt, Eric Vignon, Marc C. Hochberg, M Piperno, M.-p. Hellio Le GraverandAbstract:To ascertain the importance of alignment of the Medial Tibial Plateau (MTP), as determined by the distance between the anterior and posterior margins of the Plateau (intermargin distance [IMD]), for measurements of joint space width (JSW) in radiographs of normal knees. JSW and IMD were measured in paired baseline and 12-month knee films of 122 subjects from the osteoarthritis initiative (OAI). Relationships between JSW and IMD, and between the variation in JSW and variation in IMD, were evaluated. In cross-sectional analysis, a non-linear relationship existed between JSW and the concurrent IMD. With poor MTP alignment (IMD>1.7 mm), a 1.0-mm increase in IMD resulted in a 0.16-mm (95%CI: 0.11-0.21) increase in JSW (P<0.0001). In a longitudinal analysis, the effect of IMD variation on variation in JSW was also highly significant (P<0.0001). A variation of 1 mm between IMD(Baseline) and IMD(12month) was associated with a 0.10-mm (95% CI: 0.06-0.13) variation in JSW, with variations in JSW and IMD occurring in the same direction. An IMD variation less than or equal to 1.0mm was determined to be acceptable for accurate evaluation of JSW in serial radiographs. The error in measurement of JSW caused by variation in IMD in serial radiographs of normal knees can be as large, or larger, than the mean rate of 12-month joint space narrowing (JSN) in OA knees. MTP alignment and replication of alignment in serial knee films are required for accurate determination of JSN in OA knee. Copyright © 2012. Published by Elsevier SAS.
-
Alignment of the Medial Tibial Plateau affects the rate of joint space narrowing in the osteoarthritic knee.
Osteoarthritis and cartilage, 2010Co-Authors: Eric Vignon, Kenneth D Brandt, Catherine Mercier, Marc C. Hochberg, David J. Hunter, S.a. Mazzuca, Kimerly A. Powell, B. Wyman, M.-p. Hellio Le GraverandAbstract:Summary Objective To determine, in serial fixed-flexion (FF) radiographs of subjects with knee osteoarthritis (KOA), the importance of, and basis for, the effect of alignment of the Medial Tibial Plateau (MTP), as determined by the inter-margin distance (IMD), on joint space narrowing (JSN). Methods Baseline and 12-month X-rays of 590 knees with Kellgren and Lawrence grade (KLG) 2/3 OA from the public-release dataset of the Osteoarthritis Initiative (OAI) were assigned to subgroups based upon IMD at baseline (IMD BL ) and the difference between IMD BL and IMD 12mos . Relationships of JSN to IMD BL and to the difference between IMD BL and IMD 12mos were evaluated. Results In all 590 knees, mean JSN was 0.13±0.51mm ( P BL in the 12-month film were, in general, poor. JSN was significantly ( P =0.012) more rapid in Subgroup A (IMD≤1.70mm at both time points) than in Subgroup B (both IMDs>1.70mm): 0.15±0.43; 0.08±0.47. Within Subgroup B we identified a subset, Subgroup B1, in which, although alignment was poor at both time points, the large IMD BL was, by chance, highly reproduced by IMD 12mos (difference between the two IMDs=0.01±0.27mm, NS). JSN in Subgroup B1 was 0.06±0.41mm and did not differ from that in other knees of Subgroup B ( P =0.87). The standardized response mean (SRM) in all 590 knees and Subgroups A, B and B1 was 0.25, 0.34, 0.17 and 0.06, respectively. Independent of IMD BL , JSN correlated significantly with the difference between the IMDs in the two radiographs ( r =0.17, P =0.0001). Conclusion Skewed MTP alignment in serial films and poor replication of IMD BL in the follow-up exam affect JSN measurement. The magnitude of change in joint space width (JSW) related to the poor quality of alignment that is common with the FF view jeopardizes accurate evaluation of JSN.