Relationship between radiological grading and clinical status in knee osteoarthritis. a multicentric studyReport as inadecuate

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BMC Musculoskeletal Disorders

, 13:194

Clinical diagnostics and imaging


BackgroundControversy exists regarding the relationship between radiographic findings and clinical status in knee osteoarthritis. Although the surgical indication for total knee arthroplasty TKA should be based on pain, clinical status, and the deterioration of quality of life, the radiographic study is the most commonly used criterion for preoperative evaluation. The objective of this study is to find out the relationship between the Ahlbäck classification and clinical status in patients undergoing TKA.

Methods1329 protocols were collected from preoperative studies in four multicentric working groups the Interax, Duracon, Scorpio, and Triathlon Spanish groups in 30 Spanish hospitals. Mean age was 70.4 years SD: 6.8; range: 35 to 98; 76.3% of patients were women. Patients entered the study whenever the surgeon found that medical treatment was insufficient to control pain and functional limitation. Data were collected using electronic Case Report Forms, and included Ahlbäck grading scores, Hospital for Special Surgery Knee Score HSS, SF-12, and other clinical and epidemiologic variables.

ResultsAccording to the Ahlbäck grading system, patients were divided as follows: 243 grade I 18.3%, 358 grade II 26.9%, 416 grade III 31.3%, 241 grade IV 18.1%, and 71 grade V 5.3%. As for HSS, the following scores were obtained: <60 points in 925 patients 69.6%, 60 to 69 points in 286 patients 21.5%, 70 to 84 points in 112 patients 8.4% and 85 to 100 points in 6 patients 0.5%. Scores showed a statistically significant difference depending on Ahlbäck grade, with a clear tendency towards decrease in HSS scores as the Ahlbäck grade increases p<0.001. However, the HSS score difference between Ahlbäck grades I and V was of 9.56 points only. Comparing the status of the patients at the start 1994 and at the end 2010 of the data collection process, we observed that patients who underwent surgery in the last years were older and showed a lower Ahlbäck grade.

ConclusionsWe found a relationship between Ahlbäck grading and the preoperative clinical score. The range of variability of the HSS score between the different Ahlbäck grades is small.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2474-13-194 contains supplementary material, which is available to authorized users.

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Author: Daniel Hernández-Vaquero - José Manuel Fernández-Carreira


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