ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2020
The SIFK score: a validated predictive model for arthroplasty progression after subchondral insufficiency fractures of the knee.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 37 citations in OpenAlex.
- Meniscal Extrusion: A Key Modifiable Driver of Meniscal and Cartilage Degeneration.Current reviews in musculoskeletal medicine · 2026Review
- Current Concepts in Artificial Intelligence-Assisted Arthroplasty: A Review of the Perioperative Pathway.Cureus · 2025Review
- Histopathological evaluation of spontaneous osteonecrosis of the knee: time to reconsider history and nomenclature-a scoping review.Musculoskeletal surgery · 2025Article
- Subchondral insufficiency fracture of the knee.Orthopadie (Heidelberg, Germany) · 2025Review
- Bone marrow lesions related to bone marrow edema syndromes and osteonecrosis.Orthopadie (Heidelberg, Germany) · 2025Review
- Conservative treatments of bone marrow lesions.Journal of experimental orthopaedics · 2025Article
- A nosographic and etiopathogenetic framework for subchondral bone marrow lesions in the knee: A narrative review.Journal of experimental orthopaedics · 2025Article
- The Relationship Between Medial Meniscal Extrusion and Outcome Measures for Knee Osteoarthritis: A Systematic Review.Orthopaedic journal of sports medicine · 2024Review
- Correlation between Subchondral Insufficiency Fracture of the Knee and Osteoarthritis Progression in Patients with Medial Meniscus Posterior Root Tear.Diagnostics (Basel, Switzerland) · 2023Article
- Meniscal Extrusion: Diagnosis, Etiology, and Treatment Options.Current reviews in musculoskeletal medicine · 2023Review
- Article
- Current Reviews in Musculoskeletal Medicine: Current Controversies for Treatment of Meniscus Root Tears.Current reviews in musculoskeletal medicine · 2022Review
- A Machine Learning Algorithm Outperforms Traditional Multiple Regression to Predict Risk of Unplanned Overnight Stay Following Outpatient Medial Patellofemoral Ligament Reconstruction.Arthroscopy, sports medicine, and rehabilitation · 2022Article
- Artificial intelligence and machine learning: an introduction for orthopaedic surgeons.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
- Extrusion of the medial meniscus is a potential predisposing factor for post-arthroscopy osteonecrosis of the knee.BMC musculoskeletal disorders · 2021Article
- Artificial Learning and Machine Learning Decision Guidance Applications in Total Hip and Knee Arthroplasty: A Systematic Review.Arthroplasty today · 2021Article
- Machine learning can reliably identify patients at risk of overnight hospital admission following anterior cruciate ligament reconstruction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2021Article
- Early tibial component loosening of medial UKA after severe medial plateau SONK-report of three cases.Journal of surgical case reports · 2021Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study was to create a predictive model utilizing baseline demographic and radiographic characteristics for the likelihood that a patient with subchondral insufficiency fracture of the knee will progress to knee arthroplasty with emphasis on clinical interpretability and usability.
methodsA retrospective review of baseline and final radiographs in addition to MRIs were reviewed for evaluation of insufficiency fractures and associated injuries. Patient and radiographic factors were used in building predictive models for progression to arthroplasty with Train: Validation: Test subsets. Multiple models were compared with emphasis on clinical utility.
resultsTotal of 249 patients with a mean age of 64.6 (SD 10.5) years were included. Knee arthroplasty rate was 27% at mean of 4 years of follow-up. Lasso Regression was non-inferior to other models and was chosen for ease of interpretability. In order of importance, predictors for progression to arthroplasty included lateral meniscus extrusion, Kellgren-Lawrence Grade 4, SIFK on MFC, lateral meniscus root tear, and medial meniscus extrusion. The final SIFK Score stratified patients into low-, medium-, and high-risk categories with arthroplasty rates of 8.8%, 40.4%, and 78.9% (p < 0.001) and an area under the curve of 82.5%.
conclusionIn this validated model, lateral meniscus extrusion, K-L Grade 4, SIFK on MFC, lateral meniscus root tear, and medial meniscus extrusion were the most important factors in predicting progression to arthroplasty (in that order). This model assists in patient treatment and counseling in providing prognostic information based on patient-specific risk factors by classifying them into a low-, medium-, and high-risk categories. This model can be used both by medical professionals treating musculoskeletal injuries in guiding patient decision making. LEVEL OF EVIDENCE: Level III.
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