Evidence map›Paper›PMID 38216739›Full record

ArticleArchives of orthopaedic and trauma surgery2024

Valgus stress radiographs have a minor additional value in detecting lateral cartilage wear when selecting patients for medial partial knee replacement.

Stephan J van Langeveld, Stein J Janssen, Iris Koenraadt-van Oost, Maaike P Terra, Rutger C I van Geenen

Open access · hybridAbstract read
In one paragraph

Article in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Stephan J van LangeveldDepartment of Orthopaedic Surgery, FORCE (Foundation for Orthopaedic Research Care and Education), Amphia Hospital, Molengracht 21, 4818CK, Breda, The Netherlands. vanlangeveldstephan@gmail.com.ORCID http://orcid.org/0000-0003-1840-8867
Stein J JanssenDepartment of Orthopedic Surgery and Sports Medicine, Academic Medical Center, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Iris Koenraadt-van OostDepartment of Orthopaedic Surgery, FORCE (Foundation for Orthopaedic Research Care and Education), Amphia Hospital, Molengracht 21, 4818CK, Breda, The Netherlands.
Maaike P TerraDepartment of Radiology, Amphia Hospital, Molengracht 21, 4818CK, Breda, The Netherlands.
Rutger C I van GeenenDepartment of Orthopaedic Surgery, FORCE (Foundation for Orthopaedic Research Care and Education), Amphia Hospital, Molengracht 21, 4818CK, Breda, The Netherlands.
Amphia Ziekenhuis · NLUniversity Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionA valgus stress radiograph, in addition to the weight-bearing fixed flexion posteroanterior radiograph (e.g., Rosenberg), is deemed useful to assess lateral cartilage wear by measuring lateral joint space width (JSW) in patients with medial knee osteoarthritis. This study aimed to assess: (1) the difference in measured lateral JSW between the Rosenberg and the valgus stress radiograph, and (2) the ability of the valgus stress radiograph to detect lateral cartilage wear (indicated by joint space narrowing) in patients where the Rosenberg radiograph showed full thickness cartilage (i.e., the additional value). MATERIALS AND

methodsThe Rosenberg and valgus stress radiographs, obtained between January 1st 2018 and December 31st 2018, of 137 patients with medial knee osteoarthritis prior to total or partial knee replacement were retrospectively collected. The lateral JSW was measured at its midpoint (midJSW) and minimum (minJSW). The differences were tested with a paired-sample t test. The valgus stress radiograph was considered to have an additional value if: (1) JSW ≥ 5 mm on the Rosenberg radiograph, (2) JSW < 5 mm on valgus stress radiograph, and (3) > 2 mm less JSW on the valgus stress than on the Rosenberg radiograph.

resultsThe mean differences in lateral JSW between the Rosenberg and valgus stress radiographs were 0.53 mm (SD = 1.0 mm, p < 0.001) for midJSW and 0.66 mm (SD = 1.1 mm, p < 0.001) for minJSW with both values being lower on the valgus stress radiograph. The valgus stress radiograph was of additional value in 4-6% of the patients.

conclusionsAlthough the valgus stress radiograph shows more lateral JSW narrowing compared to Rosenberg radiograph, it only has an additional value in 1 out of 17-25 patients with medial osteoarthritis. We, therefore, recommend a Rosenberg radiograph as routine radiographic assessment and only use an additional valgus stress radiograph in case of discrepancy between clinical and radiological findings.

Indexed as

Arthroplasty, Replacement, KneeOsteoarthritis, KneeCartilageHumansKnee JointPatient SelectionRetrospective StudiesLateral joint space widthMedial knee osteoarthritisValgus stress radiograph

Identifiers

PMID38216739
PMCPMC10965667
OpenAlexW4390788543

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.