ArticleJournal of experimental orthopaedics2024
A proposed modification to the Kellgren and Lawrence classification for knee osteoarthritis using a compartment-specific approach.
Article in Journal of experimental orthopaedics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Predictive Performance of Raman Spectroscopy in Osteoarthritis: A Systematic Review.Journal of medical systems · 2025Pooled it
- Larger preoperative medial meniscus extrusion is associated with insufficient pain relief following pullout repair for medial meniscus posterior root tears.Journal of experimental orthopaedics · 2026Article
- Medial femoral condyle bone mineral density is associated with subchondral insufficiency fractures in female patients with medial meniscus posterior root tears.Journal of experimental orthopaedics · 2026Article
- CT protocols for lower limb arthroplasty: the Stanmore hip and knee protocols.EFORT open reviews · 2026Review
- A novel approach in diagnosing knee osteoarthritis for content based image retrieval in big data analytics and medical images.Scientific reports · 2025Article
- Medial degenerative disease of the knee without radiographic osteoarthritis is a good indication for medial open wedge high tibial osteotomy.Archives of orthopaedic and trauma surgery · 2024Article
- Evaluation of Oxidative Stress and Cellular Immunity in Grades III-IV Knee Osteoarthritis.The archives of bone and joint surgery · 2024Article
- A proposed modification to the Kellgren and Lawrence classification for knee osteoarthritis using a compartment-specific approach.Journal of experimental orthopaedics · 2024Article
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12 authors.
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Abstract
Purpose: Since Kellgren and Lawrence (KL) originally classified knee osteoarthritis, several authors have reported varying levels of reliability and a lack of uniformity in the use of this classification system. We propose several modifications to the KL classification including the use of a compartment-specific approach that we hypothesize will lead to a better understanding of knee OA while maintaining an adequate interobserver and intraobserver reliability. Methods: We propose the addition of the lateral and skyline-view radiographs to the standard anteroposterior (AP) and lateral projections in the evaluation. Also suggest a more precise definition of the evaluated parameters; the addition of the subchondral cancellous bone as parameter of evaluation; and the assessment of medial tibiofemoral compartment (MTFC), lateral tibiofemoral compartment (LTFC) and patellofemoral compartment (PFC) separately resulting in a compartment-specific KL staging score rather than a single overall KL score. Six evaluators (two knee surgeons, two radiologists and two knee fellows) used the modified KL classification to classify 230 randomly selected knees on two separate occasions. Reliabilities were assessed by calculating Krippendorff's Results: Two hundred and ten knees were included for final evaluation and analyses (53% left knees; 65% females; mean age 56 years old). Average interobserver reliability was moderate for all compartments (0.51 for the MTFC; 0.51 for the LTFC; and 0.56 for the PFC). Average intraobserver reliability was substantial for all compartments (0.63 for the MTFC; 0.65 for the LTFC; and 0.7 for the PFC). Experienced evaluators showed a higher intraobserver reliability than less-experienced evaluators. Conclusions: A modified compartment-specific KL classification enables a practical and detailed description of knee OA involvement and demonstrates acceptable interobserver and intraobserver reliability.
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