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

• Published in: BMC musculoskeletal disorders 2013-06, Vol.14 (1), p.194-194, Article 194
• Main Authors: Yamabe, Eiko, Ueno, Teruko, Miyagi, Ryo, Watanabe, Atsuya, Guenzi, Christine, Yoshioka, Hiroshi
• Format: Article
• Language: English
• Subjects: Aged; Arthritis; Arthroplasty - methods; Arthroplasty, Replacement, Knee - statistics & numerical data; Bone marrow; Care and treatment; Cartilage; Cartilage, Articular - pathology; Consent; Cysts; Diagnosis; Edema; Female; Health aspects; Humans; Joint replacement surgery; Knee; Knee Joint - pathology; Knee Joint - surgery; Ligaments; Magnetic Resonance Imaging; Male; Middle Aged; Orthopedics; Osteoarthritis; Osteoarthritis, Knee - pathology; Osteoarthritis, Knee - surgery; Patient satisfaction; Postoperative Complications; Retrospective Studies
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/1471-2474-14-194

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. 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. 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