Skip to main content
Log in

Coronal tibiofemoral subluxation in knee osteoarthritis

  • Scientific Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

To analyze knees in varying stages of osteoarthritis (OA) for the presence of coronal tibiofemoral (CTF) subluxation and to determine if CTF subluxation severity is related to knee OA worsening.

Methods

We retrospectively evaluated CTF subluxation and limb alignment in 113 patients with different stages of knee OA who were being considered for an arthroplasty procedure. Knee OA was classified as “mild” or “severe” according to Kellgren-Lawrence scale. CTF subluxation was measured in the study groups and in 40 knees of healthy controls using software developed specifically on the basis of Iterative Closest Point mathematical algorithm.

Results

Mean CTF subluxation in “mild OA” and “severe OA” groups was 3.5 % (±2) and 3.5 % (±5) of the tibial plateau, respectively. For both the mild and severe OA groups, CTF subluxation was significantly increased compared to the 1.4 % (±1) CTF subluxation in the control group, (p < 0.0001) and (p = 0.012), respectively. However, there was no significant difference in CTF subluxation between the mild OA and severe OA groups (p = 0.75). Limb varus malalignment in mild OA and severe OA groups was 3.6° (±2.2) and 5.3° (±2.6), respectively. Both significantly increased comparing to the 1° (±0.7) control group alignment (p < 0.0001). Varus malalignment in the severe OA group was significantly increased comparing to the mild OA group (p = 0.0003).

Conclusions

CTF subluxation is a radiographic finding related to knee OA which occurs mainly in the early stages of the osteoarthritic process and stagnates as OA progresses.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Salaffi F, Carotti M, Stancati A, Grassi W. Health-related quality of life in older adults with symptomatic hip and knee osteoarthritis: a comparison with matched healthy controls. Aging Clin Exp Res. 2005;17(4):255–63.

    Article  PubMed  Google Scholar 

  2. Felson D, Niu J, Sack B, Aliabadi P, McCullough C, Nevitt MC. Progression of osteoarthritis as a state of inertia. Ann Rheum Dis. 2012;72(6):924–9.

    Article  PubMed  Google Scholar 

  3. Hunter DJ, Sharma L, Skaife T. Alignment and osteoarthritis of the knee. J Bone Joint Surg Am. 2009;91 Suppl 1:85–9.

    Article  PubMed  Google Scholar 

  4. Reijman M, Pols HA, Bergink AP, Hazes JM, Belo JN, Lievense AM, et al. Body mass index associated with onset and progression of osteoarthritis of the knee but not of the hip: the Rotterdam Study. Ann Rheum Dis. 2007;66(2):158–62.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Brouwer GM, van Tol AW, Bergink AP, Belo JN, Bernsen RM, Reijman M, et al. Association between valgus and varus alignment and the development and progression of radiographic osteoarthritis of the knee. Arthritis Rheum. 2007;56(4):1204–11.

    Article  CAS  PubMed  Google Scholar 

  6. Cerejo R, Dunlop DD, Cahue S, Channin D, Song J, Sharma L. The influence of alignment on risk of knee osteoarthritis progression according to baseline stage of disease. Arthritis Rheum. 2002;46(10):2632–6.

    Article  PubMed  Google Scholar 

  7. Tetsworth K, Paley D. Malalignment and degenerative arthropathy. Orthoped Clin North Am. 1994;25(3):367–77.

    CAS  Google Scholar 

  8. Roos H, Adalberth T, Dahlberg L, Lohmander LS. Osteoarthritis of the knee after injury to the anterior cruciate ligament or meniscus: the influence of time and age. Osteoarthritis and cartilage/OARS. Osteoarthr Res Soc. 1995;3(4):261–7.

    Article  CAS  Google Scholar 

  9. Chang CB, Koh IJ, Seo ES, Kang YG, Seong SC, Kim TK. The radiographic predictors of symptom severity in advanced knee osteoarthritis with varus deformity. Knee. 2011;18(16):456–60.

    Article  PubMed  Google Scholar 

  10. Berger RA, Della Valle CJ. Unicompartmental knee arthroplasty: indications, techniques, and results. Instr Course Lect. 2010;59:47–56.

    PubMed  Google Scholar 

  11. Nam D, Khamaisy S, Gladnick BP, Paul S, Pearle AD. Is tibiofemoral subluxation correctable in unicompartmental knee arthroplasty? J Arthroplast. 2013;28(9):1575–9.

    Article  Google Scholar 

  12. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16(4):494–502.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Besl PJ, McKay ND. A method for registration of 3-D shapes. IEEE Trans Pattern Anal Mach Intell. 1992;14(2):239–56.

    Article  Google Scholar 

  14. Khamaisy S, Zuiderbaan HA, Thein R, Nawabi DH, Joskowicz L, Pearle AD. Coronal tibiofemoral subluxation: a new measurement method. Knee. 2014;21(6):1069–71.

    Article  PubMed  Google Scholar 

  15. Munro BH. Statistical methods for health care research. 3rd ed. Philadelphia: Lippincott; 1997.

    Google Scholar 

  16. Sharma L, Lou C, Felson DT, Dunlop DD, Kirwan-Mellis G, Hayes KW, et al. Laxity in healthy and osteoarthritic knees. Arthritis Rheum. 1999;42(5):861–70.

    Article  CAS  PubMed  Google Scholar 

  17. Sharma L, Hayes KW, Felson DT, Buchanan TS, Kirwan-Mellis G, Lou C, et al. Does laxity alter the relationship between strength and physical function in knee osteoarthritis? Arthritis Rheum. 1999;42(1):25–32.

    Article  CAS  PubMed  Google Scholar 

  18. Tanamas S, Hanna FS, Cicuttini FM, Wluka AE, Berry P, Urquhart DM. Does knee malalignment increase the risk of development and progression of knee osteoarthritis? A systematic review. Arthritis Rheum. 2009;61(4):459–67.

    Article  PubMed  Google Scholar 

  19. Wong J, Steklov N, Patil S, Flores-Hernandez C, Kester M, Colwell Jr CW, et al. Predicting the effect of tray malalignment on risk for bone damage and implant subsidence after total knee arthroplasty. J Orthopaed Res Off Publ Orthopaed Res Soc. 2011;29(3):347–53.

    Article  Google Scholar 

  20. Halder A, Kutzner I, Graichen F, Heinlein B, Beier A, Bergmann G. Influence of limb alignment on mediolateral loading in total knee replacement: in vivo measurements in five patients. J Bone Joint Surg Am. 2012;94(11):1023–9.

    Article  PubMed  Google Scholar 

  21. Lee YS, Seon JK, Shin VI, Kim GH, Jeon M. Anatomical evaluation of CT-MRI combined femoral model. Biomed Eng. 2008;7:6.

    Google Scholar 

  22. Beek M, Small CF, Ellis RE, Sellens RW, Pichora DR. Bone alignment using the iterative closest point algorithm. J Appl Biomech. 2010;26(4):526–30.

    PubMed  Google Scholar 

  23. Popescu F, Viceconti M, Grazi E, Cappello A. A new method to compare planned and achieved position of an orthopaedic implant. Comput Methods Prog Biomed. 2003;71(2):117–27.

    Article  Google Scholar 

  24. Citak M, Suero EM, Citak M, Dunbar NJ, Branch SH, Conditt MA, et al. Unicompartmental knee arthroplasty: is robotic technology more accurate than conventional technique? Knee. 2012.

Download references

Source of funding

None

Compliance with ethical standards

None

Conflict of interest

No conflict of interest

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Saker Khamaisy.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Khamaisy, S., Zuiderbaan, H.A., Thein, R. et al. Coronal tibiofemoral subluxation in knee osteoarthritis. Skeletal Radiol 45, 57–61 (2016). https://doi.org/10.1007/s00256-015-2244-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-015-2244-z

Keywords

Navigation