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Open Access 29-08-2024 | Magnetic Resonance Imaging | Orthopaedic Surgery

Anteromedial knee osteoarthritis (AMOA) evaluated with magnetic resonance imaging (MRI): a cohort study of 100 patients

Authors: Kristine Ifigenia Bunyoz, Joseph Dixon, Jaison Patel, Anders Troelsen, Abtin Alvand, Will Jackson, Andrew Price, Nicholas Bottomley

Published in: Archives of Orthopaedic and Trauma Surgery

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Abstract

Introduction

Magnetic resonance imaging (MRI) scans are increasingly used for knee osteoarthritis evaluation and preoperative planning before unicompartmental knee arthroplasty (UKA), and often patients already have MRI scans before their initial surgeon consultation. This highlights the need for surgeons to understand anteromedial osteoarthritis (AMOA) patterns on MRI. Hence, we aim to describe MRI findings in patients with AMOA meeting current indications for medial UKA.

Materials and methods

We analysed MRI scans from 100 knees evaluated for UKA between 2006 and 2013. Inclusion criteria comprised full-thickness medial compartment loss and intact lateral compartment joint space on preoperative radiographs. Assessment included cartilage lesions, osteophytes, meniscal damage, and anterior-cruciate ligament (ACL) status on tibial and femoral surfaces. Final decision to proceed with UKA relied on intraoperative findings, independent of MRI.

Results

Complete anteromedial tibial and femoral cartilage loss preserved posterior cartilage rims was evident in all cases. Cartilage thinning occurred in the lateral compartment in 34% of cases. While 62% displayed lateral osteophytes, only 6 exhibited small areas of full-thickness cartilage loss. ACL abnormalities varied: 27% normal, 3% ruptured, and 70% had intrasubstance high signal. Larger osteophytes in the medial (p = 0.012) and lateral (p = 0.002) intercondylar notch correlated significantly with ACL damage. All underwent medial UKA, with no evidence of areas with full lateral compartment cartilage loss intraoperatively.

Conclusions

The MRI findings confirmed the radiographic diagnosis of bone-on-bone medial disease but highlights a range of findings in the ACL, lateral compartment, and patellofemoral joint compartment for patients who met the current x-ray and intraoperative indication for UKA. Further research is required to understand if these MRI changes will affect long-term outcomes.
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Literature
4.
go back to reference Goodfellow J, O’Connor J, Murray DW, Dodd C (2006) Unicompartmental arthroplasty with the Oxford knee. Oxford University Press Goodfellow J, O’Connor J, Murray DW, Dodd C (2006) Unicompartmental arthroplasty with the Oxford knee. Oxford University Press
8.
go back to reference Plancher KD, Berend KR, Dalury DF, Lombardi AVJ (2023) Unicondylar knee arthroplasty made simple. Instr Course Lect 72:261–272PubMed Plancher KD, Berend KR, Dalury DF, Lombardi AVJ (2023) Unicondylar knee arthroplasty made simple. Instr Course Lect 72:261–272PubMed
13.
go back to reference Keyes GW, Carr AJ, Miller RK, Goodfellow JW, Keyes GW, Carr AJ, Miller RK, Goodfellow JW, Keyes GW, Carr AJ, Miller RK, Goodfellow JW (1992) The radiographic classification of medial gonarthrosis the radiographic classification of medial gonarthrosis correlation with operation methods in 200 knees. Acta Orthop Scand 63:497–501. https://doi.org/10.3109/17453679209154722CrossRefPubMed Keyes GW, Carr AJ, Miller RK, Goodfellow JW, Keyes GW, Carr AJ, Miller RK, Goodfellow JW, Keyes GW, Carr AJ, Miller RK, Goodfellow JW (1992) The radiographic classification of medial gonarthrosis the radiographic classification of medial gonarthrosis correlation with operation methods in 200 knees. Acta Orthop Scand 63:497–501. https://​doi.​org/​10.​3109/​1745367920915472​2CrossRefPubMed
18.
go back to reference Crema MD, Guermazi A, Li L, Nogueira-Barbosa MH, Marra MD, Roemer FW, Eckstein F, Hellio Le Graverand MP, Wyman BT, Hunter DJ (2010) The association of prevalent medial meniscal pathology with cartilage loss in the medial tibiofemoral compartment over a 2-year period. Osteoarthr Cartil 18:336–343. https://doi.org/10.1016/j.joca.2009.11.003CrossRef Crema MD, Guermazi A, Li L, Nogueira-Barbosa MH, Marra MD, Roemer FW, Eckstein F, Hellio Le Graverand MP, Wyman BT, Hunter DJ (2010) The association of prevalent medial meniscal pathology with cartilage loss in the medial tibiofemoral compartment over a 2-year period. Osteoarthr Cartil 18:336–343. https://​doi.​org/​10.​1016/​j.​joca.​2009.​11.​003CrossRef
23.
go back to reference Disler DG, Mccauley TR, Kelman C, Fuchs MD, Ratner LM, Wirth CR, Hospodar PP (1996) Knee : comparison with standard imaging and arthroscopy. Area 127–132 Disler DG, Mccauley TR, Kelman C, Fuchs MD, Ratner LM, Wirth CR, Hospodar PP (1996) Knee : comparison with standard imaging and arthroscopy. Area 127–132
Metadata
Title
Anteromedial knee osteoarthritis (AMOA) evaluated with magnetic resonance imaging (MRI): a cohort study of 100 patients
Authors
Kristine Ifigenia Bunyoz
Joseph Dixon
Jaison Patel
Anders Troelsen
Abtin Alvand
Will Jackson
Andrew Price
Nicholas Bottomley
Publication date
29-08-2024
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-024-05511-2