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Archives of Orthopaedic and Trauma Surgery

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Open Access 12-01-2024 | Knee Osteoarthritis | Knee Arthroplasty

Valgus stress radiographs have a minor additional value in detecting lateral cartilage wear when selecting patients for medial partial knee replacement

Authors: Stephan J. van Langeveld, Stein J. Janssen, Iris Koenraadt-van Oost, Maaike P. Terra, Rutger C. I. van Geenen

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 4/2024

Abstract

Introduction

A valgus stress radiograph, in addition to the weight-bearing fixed flexion posteroanterior radiograph (e.g., Rosenberg), is deemed useful to assess lateral cartilage wear by measuring lateral joint space width (JSW) in patients with medial knee osteoarthritis. This study aimed to assess: (1) the difference in measured lateral JSW between the Rosenberg and the valgus stress radiograph, and (2) the ability of the valgus stress radiograph to detect lateral cartilage wear (indicated by joint space narrowing) in patients where the Rosenberg radiograph showed full thickness cartilage (i.e., the additional value).

Materials and methods

The Rosenberg and valgus stress radiographs, obtained between January 1st 2018 and December 31st 2018, of 137 patients with medial knee osteoarthritis prior to total or partial knee replacement were retrospectively collected. The lateral JSW was measured at its midpoint (midJSW) and minimum (minJSW). The differences were tested with a paired-sample t test. The valgus stress radiograph was considered to have an additional value if: (1) JSW ≥ 5 mm on the Rosenberg radiograph, (2) JSW < 5 mm on valgus stress radiograph, and (3) > 2 mm less JSW on the valgus stress than on the Rosenberg radiograph.

Results

The mean differences in lateral JSW between the Rosenberg and valgus stress radiographs were 0.53 mm (SD = 1.0 mm, p < 0.001) for midJSW and 0.66 mm (SD = 1.1 mm, p < 0.001) for minJSW with both values being lower on the valgus stress radiograph. The valgus stress radiograph was of additional value in 4–6% of the patients.

Conclusions

Although the valgus stress radiograph shows more lateral JSW narrowing compared to Rosenberg radiograph, it only has an additional value in 1 out of 17–25 patients with medial osteoarthritis. We, therefore, recommend a Rosenberg radiograph as routine radiographic assessment and only use an additional valgus stress radiograph in case of discrepancy between clinical and radiological findings.

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Title: Valgus stress radiographs have a minor additional value in detecting lateral cartilage wear when selecting patients for medial partial knee replacement
Authors: Stephan J. van Langeveld
Stein J. Janssen
Iris Koenraadt-van Oost
Maaike P. Terra
Rutger C. I. van Geenen
Publication date: 12-01-2024
Publisher: Springer Berlin Heidelberg
Keywords: Knee Osteoarthritis
Knee Osteoarthritis
Knee-TEP
Knee-TEP
Osteoarthrosis
Osteoarthrosis
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 4/2024
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-023-05187-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Valgus stress radiographs have a minor additional value in detecting lateral cartilage wear when selecting patients for medial partial knee replacement

Abstract

Introduction

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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