ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2015
Defining the presence of radiographic knee osteoarthritis: a comparison between the Kellgren and Lawrence system and OARSI atlas criteria.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 2 of them syntheses that pooled it.
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Who cites it
60 citing papers in PubMed, 2 syntheses or guidelines pooled it, 123 citations in OpenAlex.
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- Knee skin temperature following unicompartmental knee arthroplasty and its relationship with inflammatory indicators.Journal of experimental orthopaedics · 2026Article
- Integrative Phenotyping of Knee Osteoarthritis: Linking WOMAC Cut-Offs, Kellgren-Lawrence Grades, and Cluster Analysis for Personalized Care.Life (Basel, Switzerland) · 2025Article
- Classification models for arthropathy grades of multiple joints based on hierarchical continual learning.La Radiologia medica · 2025Article
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- Prevalence of osteoarthritis and clinical outcomes in patients with fractures of the tibial plateau - medium- and long-term analysis.BMC musculoskeletal disorders · 2025Observational
- Artificial Intelligence Model Assists Knee Osteoarthritis Diagnosis via Determination of K-L Grade.Diagnostics (Basel, Switzerland) · 2025Article
- Clinical, Functional, Sports Participation, and Osteoarthritis Outcomes After ACL Injury: Ten-Year Follow-up Study of the Delaware-Oslo ACL Cohort Treatment Algorithm.The Journal of bone and joint surgery. American volume · 2025Article
- Association of radiographic structure deformity phenotypes of knee OA to clinical symptoms and risk for progression: Proposing a modification of Kellgren-Lawrence grade - Data from the Osteoarthritis Initiative and the MOST study.Osteoarthritis and cartilage open · 2025Article
- ShapeMed-Knee: A Dataset and Neural Shape Model Benchmark for Modeling 3D Femurs.IEEE transactions on medical imaging · 2025Article
- Classification approaches used to grade radiographic patellofemoral osteoarthritis: A scoping review.Osteoarthritis imaging · 2025Article
- Posttraumatic osteoarthritis after athletic knee injury: A narrative review of diagnostic imaging strategies.PM & R : the journal of injury, function, and rehabilitation · 2025Review
- A Review for automated classification of knee osteoarthritis using KL grading scheme for X-rays.Biomedical engineering letters · 2025Review
- ShapeMed-Knee: A Dataset and Neural Shape Model Benchmark for Modeling 3D Femurs.medRxiv : the preprint server for health sciences · 2024Article
- Artificial intelligence in musculoskeletal imaging: realistic clinical applications in the next decade.Skeletal radiology · 2024Review
- Single Stance Radiography of the Knee Joint - A Novel Approach to Assess the Degree of Knee Osteoarthritis.Journal of orthopaedic case reports · 2024Article
- Deep learning applications in osteoarthritis imaging.Skeletal radiology · 2023Review
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe Kellgren and Lawrence (K/L) system and Osteoarthritis Research Society International (OARSI) atlas are frequently used to define radiographic knee osteoarthritis (OA). The purpose of the current study was to determine the extent to which tibiofemoral OA rates differ between the K/L system and OARSI atlas criteria and to compare qualitative (K/L and OARSI) and quantitative (millimetres) measures of joint space narrowing (JSN).
methodsPosteroanterior radiographs of 1,178 knees, from 621 individuals with varying severity of OA, were graded by a trained physician with the K/L system (grade 0-4) and the OARSI atlas (osteophytes/JSN graded 0-3). Using the K/L system, the presence of OA was defined with the traditional cut-off of ≥grade 2 (definite osteophyte and possible JSN) and an alternative cut-off of at least a definite osteophyte alone (≥grade 2/osteophyte). For the OARSI atlas, OA was considered present if the sum of osteophytes or JSN ≥grade 2, or grade 1 JSN occurred in combination with grade 1 osteophyte. Minimum joint space width (mJSW) was measured manually in millimetres.
resultsAccording to the K/L system (≥grade 2), 167 knees (14.2 %) had tibiofemoral OA and 203 (17.3 %) had ≥grade 2/osteophyte. In contrast, 309 knees (26.2 %) had tibiofemoral OA according to OARSI atlas criteria. K/L and OARSI JSN descriptions were significantly associated with mJSW (p < 0.022).
conclusionsRadiographic tibiofemoral OA was almost twice as common using OARSI atlas criteria compared with the K/L system. This discrepancy is likely to contribute to the large variability of OA prevalence observed in the literature and is important for clinicians to consider when diagnosing radiographic OA. The cut-off for defining radiographic knee OA using the two systems should not be considered comparable. LEVEL OF EVIDENCE: III.
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