ArticleClinical rheumatology2023
Changes in knee joint destruction patterns among patients with rheumatoid arthritis undergoing total knee arthroplasty in recent decades.
Article in Clinical rheumatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 10 citations in OpenAlex.
- CPAK classification shows limited side-to-side agreement and limited reliability as a standalone surrogate for constitutional alignment in rheumatoid arthritis knees.Journal of experimental orthopaedics · 2026Article
- Comparable revision outcomes after unicompartmental knee arthroplasty in rheumatoid arthritis and osteoarthritis : results from the German Arthroplasty Registry.Bone & joint open · 2026Article
- Osteochondral Alterations in Patients Treated with Total Knee Arthroplasty Due to Rheumatoid Arthritis and Primary Osteoarthritis: Cross-Sectional Study with Focus on Elucidating Effects of Knee Malalignment.Life (Basel, Switzerland) · 2025Article
- Experience of High Tibial Osteotomy for Patients with Rheumatoid Arthritis Treated with Recent Medication: A Case Series.Journal of clinical medicine · 2025Article
- New evidence on patella resurfacing in modern total knee arthroplasty for all inflammatory arthritis in a mixed Asian population.Journal of clinical orthopaedics and trauma · 2024Article
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study aimed to investigate the trend of joint destruction patterns on knee radiographs of patients with rheumatoid arthritis (RA) undergoing total knee arthroplasty (TKA) over the past 16 years.
methodMedial joint space, lateral joint space, medial spur area, lateral spur area (L-spur), and femoro-tibial angle were obtained from 831 preoperative knee radiographs of patients with RA who underwent TKA between 2006 and 2021 using software capable of automatic measurements. Non-hierarchical clustering was performed based on these five parameters. Trends in the five individual radiographic parameters and the ratio of each cluster were investigated during the target period. Moreover, clinical data from 244 cases were compared among clusters to identify factors associated with this trend.
resultsAll parameters, except for L-spur, showed significant increasing trends from 2006 to 2021. The radiographs were clustered into groups according to the characteristic pattern of radiographic findings: cluster 1 (conventional RA type), with bicompartmental joint space narrowing (JSN), less spur formation, and valgus alignment; cluster 2 (osteoarthritis type), with medial JSN, medial osteophytes, and varus alignment; and cluster 3 (less destructive type), with mild bicompartmental JSN, less spur formation, and valgus alignment. The ratio of cluster 1 showed a significantly decreasing trend contrary to the significantly increasing trend in clusters 2 and 3. The DAS28-CRP of cluster 3 was higher than those of clusters 1 and 2.
conclusionsRadiographs of TKA recipients with RA are increasingly presenting osteoarthritic features in recent decades. Key Points • Using automated measurement software, morphological parameters were measured from radiographs of 831 patients with rheumatoid arthritis who had undergone TKA in the past 16 years. • Cluster analysis based on the radiographic parameters revealed that the radiographs of patients with end-stage knee arthritis requiring total knee arthroplasty were classified into three groups. • In patients with rheumatoid arthritis who have undergone total knee arthroplasty in the past 16 years, the proportion of clusters with features of osteoarthritis and difficult-to-treat rheumatoid arthritis has increased, while the proportion of conventional rheumatoid arthritis has decreased.
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