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Impact of quantified knee positioning on the measurement of minimal joint space width using statistical shape models: A cross-sectional and longitudinal analysis in the IMI-APPROACH.

Title: Impact of quantified knee positioning on the measurement of minimal joint space width using statistical shape models: A cross-sectional and longitudinal analysis in the IMI-APPROACH.
Authors: Bax, Eva; Nguyen, Chien; Custers, Roel; Arbabi, Vahid; Rayegan, Hassan; Gielis, Willem Paul; Lindner,Claudia; Cootes,Tim F.; Kloppenburg,Margreet; Blanco,Francisco J; Haugen,Ida K; Berenbaum,Francis; Jansen, Mylène P.; Mastbergen, Simon; Roemer,Frank W; Eckstein,Felix; Wirth,Wolfgang; Kruyt, MC; Weinans, H; MS Orthopaedie Algemeen; DHS 3D Lab; Regenerative Medicine and Stem Cells; ORT Research; Other research (not in main researchprogram); Lab Reumatologie/Klinische Immunologie; Infection & Immunity; MS Reumatologie/Immunologie/Infectie
Publication Year: 2025
Subject Terms: Knee positioning; Minimum joint space width; Statistical shape models; Cartilage thickness; Knee osteoarthritis
Description: Objective Correlations between minimum joint space width (mJSW) and MRI-based cartilage thickness are strong in cross-sectional analyses and moderate in longitudinal analyses, possibly due to knee rotation and flexion. This study investigates the effect of knee positioning during radiographic acquisition on the difference between mJSW and MRI-based cartilage thickness. Methods Radiographic mJSW from the index knee was determined from baseline (265 patients) and 24-month follow-up (165 patients) on fixed-flexion radiographs from IMI-APPROACH (multicenter OA study) patients using automated software. Statistical Shape Models were used to quantify knee rotation and flexion on radiographs. Cartilage thickness was assessed by manual segmentation from MRI. Differences between mJSW (radiographs) and cartilage thickness (MRI) were assessed at baseline and follow-up. Multivariable linear regression was used to evaluate the impact of knee flexion and rotation on the difference between mJSW and cartilage thickness. Results In cross-sectional analysis, differences between X-ray and MRI were significantly influenced by knee rotation (β = -0.18, P < 0.001). Longitudinal change in differences between X-ray and MRI were associated with changes in knee flexion (β = 0.19, P=0.002). Increases of one standard deviation in internal rotation and extension at follow-up resulted in a 0.2 mm false surrogate measurement of cartilage changes on radiographs. Conclusion Quantified knee positioning significantly affects differences between mJSW measured on radiographs and MRI-based cartilage thickness. The longitudinal analyses revealed that knee flexion was related to these differences, while knee rotation was only related to cross-sectional differences. These findings highlight the importance of knee positioning during radiographic acquisition in contributing to false surrogate measurement of cartilage status and cartilage change.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 2772-6541
Relation: https://dspace.library.uu.nl/handle/1874/469034
Availability: https://dspace.library.uu.nl/handle/1874/469034
Rights: info:eu-repo/semantics/OpenAccess
Accession Number: edsbas.E7414192
Database: BASE