Optimum Radiographic Assessment of the Knee

Summary

X-rays are the most frequently used imaging test when evaluating the knee for joint replacement. They are non-invasive, safe and cost effective. They allow assessment of: progression of disease, appropriateness for joint replacement, in particular unicompartmental knee replacement (UKR), as well as likely prognosis following replacement. Despite a multitude of standardised views there is a lack of consensus regarding the optimum views to evaluate joint space narrowing within each compartment (lateral, medial and patellofemoral).

This study will evaluate the status of knee cartilage in 225 patients with varying degrees, and patterns, of knee osteoarthritis (OA) using standing extension anteroposterior, 15 degrees flexion posteroanterior, 45 degrees flexion posteroanterior and valgus and varus stress views as well as MRI. These results will be compared to the gold standard imaging technique of stress views as well as to direct measurements of retrieved tissue in those patients who undergo knee replacement surgery. The sensitivity and specificity of each of the imaging techniques at predicting suitability for UKR will be calculated, the optimum imaging views proposed, and ultimately the results of this study will be used to develop a decision aid, based on optimum views, to help clinicians decide between likelihood of a patient being a candidate for UKR based on pre-operative X-ray findings.

Conditions

• Osteoarthritis, Knee

Interventions

RADIATION

Valgus Stress

Valgus stress radiograph

RADIATION

Varus stress

Varus stress radiograph

RADIATION

0 degree flexion radiograph

0 degree flexion radiograph

RADIATION

20 degree flexion radiograph

20 degree flexion radiograph

RADIATION

45 degree flexion radiograph

45 degree flexion radiograph

Sponsors & Collaborators

• University of Oxford

  collaborator OTHER

• Oxford University Hospitals NHS Trust

  lead OTHER

Study Design

Allocation

NON_RANDOMIZED

Purpose

DIAGNOSTIC

Masking

SINGLE

Model

SEQUENTIAL

Eligibility

Min Age

50 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2016-10-05

Primary Completion

2017-09-01

Completion

2017-09-01