Subchondral bone expansion in advanced knee osteoarthritis: Relation with radiographic severity and role in surgical decision-making

Wei Wang; Tianshu Jiang; Jiang Zhang; Jun Liu; Lok Chun Chan; Mengqi Lin; Jia Li; Changhai Ding; Kwong Yuen Chiu; Henry Fu; Ping Keung Chan; Chunyi Wen

Osteoarthritis and Cartilage Open (Jun 2024)

Subchondral bone expansion in advanced knee osteoarthritis: Relation with radiographic severity and role in surgical decision-making

Wei Wang,
Tianshu Jiang,
Jiang Zhang,
Jun Liu,
Lok Chun Chan,
Mengqi Lin,
Jia Li,
Changhai Ding,
Kwong Yuen Chiu,
Henry Fu,
Ping Keung Chan,
Chunyi Wen

Affiliations

Wei Wang: Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
Tianshu Jiang: Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
Jiang Zhang: Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
Jun Liu: Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
Lok Chun Chan: Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China; Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China
Mengqi Lin: Department of Software Engineering, Faculty of Electrical and Computer Engineering, Jilin Jianzhu University, Changchun, China
Jia Li: Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Changhai Ding: Clinical Research Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
Kwong Yuen Chiu: Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
Henry Fu: Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
Ping Keung Chan: Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
Chunyi Wen: Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China; Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China; Corresponding author. Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University ST417, 4/F, Block S, Hong Kong SAR, China.

Journal volume & issue: Vol. 6, no. 2
p. 100461

Abstract

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Background: Joint space width (JSW) is a traditional imaging marker for knee osteoarthritis (OA) severity, but it lacks sensitivity in advanced cases. We propose tibial subchondral bone area (TSBA), a new CT imaging marker to explore its relationship with OA radiographic severity, and to test its performance for classifying surgical decisions between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) compared to JSW. Methods: We collected clinical, radiograph, and CT data from 182 patients who underwent primary knee arthroplasty (73 UKA, 109 TKA). The radiographic severity was scored using Kellgren-Lawrence (KL) grading system. TSBA and JSW were extracted from 3D CT-reconstruction model. We used independent t-test to investigate the relationship between TSBA and KL grade, and binary logistic regression to identify factors associated with TKA risk. The accuracy of TSBA, JSW and established classification model in differentiating between UKA and TKA was assessed using AUC. Results: All parameters exhibited inter- and intra-class coefficients greater than 0.966. Patients with KL grade 4 had significantly larger TSBA than those with KL grade 3. TSBA (0.708 of AUC) was superior to minimal/average JSW (0.547/0.554 of AUC) associated with the risk of receiving TKA. Medial TSBA, together with gender and Knee Society Knee Score, emerged as independent classification factors in multivariate analysis. The overall AUC of composite model for surgical decision-making was 0.822. Conclusion: Tibial subchondral bone area is an independent imaging marker for radiographic severity, and is superior to JSW for surgical decision-making between UKA and TKA in advanced OA patients.

Published in Osteoarthritis and Cartilage Open

ISSN: 2665-9131 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the musculoskeletal system
Website: https://www.journals.elsevier.com/osteoarthritis-and-cartilage-open/

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