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Objective

Objective. Investigate the relationship between radiographic JSW and cartilage quality Hypothesis : JSW is not an accurate indicator of the severity of cartilage damage in cases of OA of the knee. Materials and Methods. Prospective study 60 patients TKA for idiopathic OA

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Objective

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  1. Objective • Investigatetherelationshipbetweenradiographic JSW and cartilagequality • Hypothesis: JSW isnotanaccurateindicator of theseverity of cartilagedamage in cases of OA of theknee

  2. Materials and Methods • Prospectivestudy • 60 patients • TKA foridiopathic OA • Oneorthopedicsurgeon • Mean age 69 years (48-87) • 45 varus / 15 valgus • 35 left / 25 right • AP and lateral viewradiographs

  3. Materials and Methods • Variables • Collins Grading (grosstibialplateauimage) • Score from 1 to 4 • MankinGrading (freshcoresamples 5mm) • Score from 0 to 12 • Samplesweretakenfromthe non affectedside • JSW Measurement (mesure medial and lateral side) • 5mm or more considered normal • Kellgren and Lawrence • Score from 1 to 4

  4. Statistics • SPSS • X2 (Collins vs JSW and KL vs Collins) • Spearmanrank (Mankin vs Collins) • P<0,05

  5. Results • Valgus cases (5/15 with grade III Collins) • Average medial JSW 3,1mm • Average in grade II Collins 4,0mm • Average KL 2,4 • Varus cases (12/45 with grade III Collins) • Average lateral JSW 5,3mm • Average in grade II Collins 5,5mm • Average KL 1,4

  6. Results • No significantstatistcorrelation JSW/Collins, KL/Collins • Varuskneeswithdegradatedcontralateralcompartmentsmanteined JSW more thanvalgusknees • Collins iscorrelatedwithMankin (0,885 p<0,01) • Poorcartilagequality can befound in normal JSW

  7. Discussion • Radiographic JSW isnotanaccurateindicator of cartilagequality • Correlationbetween Collins and Mankin • Impossibletoobtain pre-op • Degeneration macro and micro notwithXrays • Whendeciding UKA, more futurerevisions • Olderpatients more arthriticprogression, but • Youngerthan 65: Mankin 8,7 • Olderthan 65: Mankin 4,4 ????

  8. Discussion • Xrays at 45º of flexion • Furtherstudiesinvestigaterelationshipbetweenradiographicviews and cartilageintegrity • Sex affect JSW (menwiderspace/ womenperimenopausaldecrease JSW) • Increasingage, decreasing JSW • Height and weight, negativecorrelationwith JSW (> valgusknees) • Weightgain no correlatedwithjointspacenarrowing

  9. Discussion • Racemayinfluence in OA • Conclusionsmaybeapplicableto HTO • Surgeonsmustevaluateintra-opto decide • No histologicor RNM examination • Increasingcost and morbidity • Patientsyoungerthan 65 and withvarusknees: JSW isnotcorrelatedwithdegradation

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