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The posterior-anterior-flexed view is essential for the evaluation of valgus osteoarthritis. A prospective study on 134 valgus knees.
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- Author(s): Rueckl K;Rueckl K;Rueckl K; Runer A; Runer A; Bechler U; Bechler U; Faschingbauer M; Faschingbauer M; Boelch SP; Boelch SP; Sculco PK; Sculco PK; Boettner F; Boettner F
- Source:
BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2019 Dec 30; Vol. 20 (1), pp. 636. Date of Electronic Publication: 2019 Dec 30.- Publication Type:
Comparative Study; Journal Article- Language:
English - Source:
- Additional Information
- Source: Publisher: BioMed Central Country of Publication: England NLM ID: 100968565 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2474 (Electronic) Linking ISSN: 14712474 NLM ISO Abbreviation: BMC Musculoskelet Disord Subsets: MEDLINE
- Publication Information: Original Publication: London : BioMed Central, [2000-
- Subject Terms: Arthroplasty, Replacement, Knee*; Knee Joint/*abnormalities ; Osteoarthritis, Knee/*diagnostic imaging ; Radiography/*methods; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Knee Joint/diagnostic imaging ; Knee Joint/surgery ; Male ; Middle Aged ; Osteoarthritis, Knee/etiology ; Osteoarthritis, Knee/surgery ; Preoperative Care/methods ; Prospective Studies
- Abstract: Background: Radiographic imaging is an important tool to assess osteoarthritis (OA). Lateral compartment osteoarthritis (valgus OA) usually starts with cartilage degeneration along the posterior aspect of the lateral femoral condyle. There is evidence that the posterior-anterior (PA)-flexed view is more sensitive when diagnosing early stages of valgus OA compared to the anterior-posterior (AP) view. The current paper analyzes the value of the PA-flexed view for patients scheduled for total knee arthroplasty (TKA).
Methods: Radiographs of 134 valgus knees were assessed prior to TKA. The minimal joint space width (minJSW) was measured on AP and PA-flexed views. The extent of mechanical deformity was measured on hip to ankle standing films.
Results: 49 (36.6%) AP views showed Kellgren and Lawrence (K/L)-grade 4 osteoarthritis in the lateral compartment, 82 (63.4%) showed grade 3 or less. The PA-flexed view resulted in an increased K/L-grading to grade 4 for 53 knees (62.4%) that were considered grade 3 or less on standard AP-radiographs. There was a significant differences between lateral minJSW on AP and PA-flexed view for patients with up to 10 degrees of mechanical valgus deformity (p < 0.001), as well as 11 to 15 degrees of mechanical deformity (p = 0.021). Only knees with severe deformity of more than 15 degrees did not show a difference in minJSW between PA-flexed view and AP view (p = 0.345).
Conclusions: The PA-flexed view is superior to the standard AP view in quantifying the extent of valgus OA in patients with zero to fifteen degrees of valgus deformity. It is recommended for the initial assessment of patients with valgus osteoarthritis and better documents the extent of osteoarthritis prior to TKA. - References: J Bone Joint Surg Br. 1990 Jul;72(4):639-40. (PMID: 2380220)
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J Biomech. 2016 Jun 14;49(9):1794-1801. (PMID: 27173594) - Contributed Indexing: Keywords: Knee; PA-flexed view; Radiographs; Valgus osteoarthritis; View
- Publication Date: Date Created: 20200101 Date Completed: 20200518 Latest Revision: 20200518
- Publication Date: 20240104
- Accession Number: PMC6937983
- Accession Number: 10.1186/s12891-019-3012-3
- Accession Number: 31888584
- Source:
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