Kellgren–Lawrence scoring system underestimates cartilage damage when indicating TKA: preoperative radiograph versus intraoperative photograph
| العنوان: | Kellgren–Lawrence scoring system underestimates cartilage damage when indicating TKA: preoperative radiograph versus intraoperative photograph |
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| المؤلفون: | Oury M Balde, Hussein Abdelaziz, Mustafa Citak, Carl Haasper, Thorsten Gehrke, Ahmed Magan |
| المصدر: | Archives of Orthopaedic and Trauma Surgery. 139:1287-1292 |
| بيانات النشر: | Springer Science and Business Media LLC, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Cartilage, Articular, musculoskeletal diseases, medicine.medical_specialty, Radiography, Context (language use), Osteoarthritis, Knee Joint, 03 medical and health sciences, 0302 clinical medicine, Image Interpretation, Computer-Assisted, Preoperative Care, Photography, Humans, Medicine, Orthopedics and Sports Medicine, Prospective Studies, Arthroplasty, Replacement, Knee, 030222 orthopedics, Intraoperative Care, business.industry, 030229 sport sciences, General Medicine, Osteoarthritis, Knee, Articular cartilage damage, musculoskeletal system, medicine.disease, Confidence interval, Orthopedic surgery, Surgery, Patella, Radiology, business |
| الوصف: | Introduction The Kellgren-Lawrence score helps the orthopedic surgeon to classify the severity of knee osteoarthritis (OA) before total knee arthroplasty (TKA). There might be a discrepancy between subjective complaints of the patients and radiologically visible changes of the knee joint in many cases. In this context, we performed a prospective clinical study to compare the preoperative degree of knee OA using the Kellgren-Lawrence score with the intraoperative extent of cartilage damage during primary TKA. Materials and methods A total of 251 primary TKA surgeries due to a primary knee OA were prospectively included. Preoperative Kellgren-Lawrence score was determined using standardized preoperative plain radiographs of three views; anteroposterior, lateral and skyline of the patella by a senior radiologist. Intraoperatively, in all cases, photographs of the medial, lateral, and patellofemoral joint compartments were taken. Using the International Cartilage Repair Society (ICRS) score, the degree of chondromalacia was assessed. Subsequently, correlation analysis was performed using the Pearson-Clopper 95% confidence interval (CI). Results There were higher intraoperative scores compared to the preoperative scores in 160 of all cases (63.7% of 251, 95% CI 57.5-69.7%). A mismatch of two score grade points was found in 8.4% (95% CI 5.3-12.5%). The most common mismatch was noted in patients with preoperative Kellgren-Lawrence score of 3 and an intraoperative score of 4 in 48.2% (95% CI 41.9-54.6%). Conclusions The preoperative radiographs using Kellgren-Lawrence underestimate the severity of knee osteoarthritis. The true extent of articular cartilage damage can be better appreciated intraoperatively. In patients undergoing primary TKA, the correlation of clinical symptoms with radiological findings is crucial in deciding when to perform the surgery. Besides, other imaging modalities may be used as an adjunct when the clinical findings and plain radiographs do not correlate. |
| تدمد: | 1434-3916 0936-8051 |
| DOI: | 10.1007/s00402-019-03223-6 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8ff979d158e9904a51ec522e2e25b13d https://doi.org/10.1007/s00402-019-03223-6 |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....8ff979d158e9904a51ec522e2e25b13d |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14343916 09368051 |
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| DOI: | 10.1007/s00402-019-03223-6 |