ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2023
Radiolucent line assessment in cemented stemmed total knee (RISK) arthroplasty: validation of a modernized classification system.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Third-generation posterior-stabilised cemented system for total knee arthroplasty: Survivorship and outcomes after 20-year follow-up.Journal of experimental orthopaedics · 2024Article
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7 authors.
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Abstract
backgroundThis study aims to implement and assess the inter- and intra-reliability of a modernized radiolucency assessment system; the Radiolucency In cemented Stemmed Knee (RISK) arthroplasty classification. Furthermore, we assessed the distribution of regions affected by radiolucency in patients undergoing stemmed cemented total knee arthroplasty.
methodsStemmed total knee arthroplasty cases over 7-year period at a single institution were retrospectively identified and reviewed. The RISK classification system identifies five zones in the femur and five zones in the tibia in both the anteroposterior (AP) and lateral planes. Post-operative and follow-up radiographs were scored for radiolucency by four blinded reviewers at two distinct time points four weeks apart. Reliability was assessed using the kappa statistic. A heat map was generated to demonstrate the reported regions of radiolucency.
results29 cases (63 radiographs) of stemmed total knee arthroplasty were examined radiographically using the RISK classification system. Intra-reliability (0.83) and Inter-reliability (0.80) scores were both consistent with a strong level of agreement using the kappa scoring system. Radiolucency was more commonly associated with the tibial component (76.6%) compared to the femoral component (23.3%), and the tibial anterior-posterior (AP) region 1 (medial plateau) was the most affected (14.9%).
conclusionThe RISK classification system is a reliable assessment tool for evaluating radiolucency around stemmed total knee arthroplasty using defined zones on both AP and lateral radiographs. Zones of radiolucency identified in this study may be relevant to implant survival and corresponded well with zones of fixation, which may help inform future research.
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