Email updates

Keep up to date with the latest news and content from BMC Musculoskeletal Disorders and BioMed Central.

Open Access Research article

Study of surgical indication for knee arthroplasty by cartilage analysis in three compartments using data from Osteoarthritis Initiative (OAI)

Eiko Yamabe12, Teruko Ueno3, Ryo Miyagi1, Atsuya Watanabe4, Christine Guenzi1 and Hiroshi Yoshioka1*

Author Affiliations

1 Department of Radiological Sciences, University of California Irvine, Irvine, CA, USA

2 Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan

3 Department of Diagnostic Radiology, Cancer Institute Hospital, Tokyo, Japan

4 Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, Chiba, Japan

For all author emails, please log on.

BMC Musculoskeletal Disorders 2013, 14:194  doi:10.1186/1471-2474-14-194

Published: 25 June 2013

Abstract

Background

Bicompartmental or unicompartmental knee arthroplasty (BKA, UKA) is currently advocated as an alternative solution to conventional total knee arthroplasty (TKA) in order to preserve bone stock and ligaments for limited osteoarthritis (OA) with intact anterior and posterior cruciate ligaments (ACL, PCL). However, the actual rate of UKA or BKA compared to TKA procedures in OA patients has not been reported. In this study, we retrospectively analyzed preoperative MRI of the knee in subjects who underwent knee arthroplasty and assessed the potential for UKA or BKA as an alternative treatment.

Methods

Data were extracted from the Osteoarthritis Initiative (OAI) public use data set, which included 4,796 subjects, ages 45–79. 3.0 Tesla MRI scanners were dedicated to imaging the knees of OAI participants annually from February 2004 to March 2010. Extensive quantitative measurements of the knee MRI were performed on 87 patients who underwent knee arthroplasty during follow-up visits. We assessed the cartilage thickness and defect size in the medial femorotibial joint (FTJ), lateral FTJ, and patellofemoral joint (PFJ) as well as ligamentous injury, bone marrow edema, and subchondral cyst size from 2D coronal turbo spin echo (TSE), 2D sagittal TSE, 3D coronal T1-weighted water-excitation fast low angle shot (FLASH), and 3D sagittal water-excitation double echo steady-state (DESS) with axial and coronal reformat images.

Results

Eighty-five subjects (97.7%) were subjected to TKA, while only 2 subjects (2.3%) received UKA from the OAI database. Based on the preoperative MRI findings criteria, 51 of 87 subjects (58.6%) met the indication for TKA including the 2 UKA subjects above. This rate was significantly lower (p<0.001) than the actual TKA rate received. Among 85 subjects who actually underwent TKA, 31 subjects (36.5%) and 5 subjects (5.9%) met the indication for BKA and UKA, respectively.

Conclusions

Many medial or lateral compartmental OA subjects, with or without patellar compartment defects have undergone TKA. The results of this study suggest the indication for partial arthroplasty, such as UKA or BKA, may increase when cartilage in each compartment, as well as ligaments and subchondral bone status are comprehensively evaluated.

Keywords:
Magnetic resonance imaging; Knee; Arthroplasty; Cartilage; Surgical indication