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

• Published in: Archives of orthopaedic and trauma surgery 2024-04, Vol.144 (4), p.1721-1732
• Main Authors: van Langeveld, Stephan J., Janssen, Stein J., Oost, Iris Koenraadt-van, Terra, Maaike P., van Geenen, Rutger C. I.
• Format: Article
• Language: English
• Subjects: Arthritis; Arthroplasty, Replacement, Knee; Cartilage; Humans; Knee; Knee Arthroplasty; Knee Joint - diagnostic imaging; Knee Joint - surgery; Medicine; Medicine & Public Health; Orthopedics; Osteoarthritis; Osteoarthritis, Knee - diagnostic imaging; Osteoarthritis, Knee - surgery; Patient Selection; Retrospective Studies
• ISSN: 1434-3916; 0936-8051; 1434-3916
• DOI: 10.1007/s00402-023-05187-0

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  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