Radiographic joint space width in patients with Crowe Type-I dysplastic hips.
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ABSTRACT:
SUBMITTER: Okano K
PROVIDER: S-EPMC2493015 | biostudies-other | 2008 Sep
REPOSITORIES: biostudies-other
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Project description:Quantification of joint space width of the ankle could provide information essential to evaluate the effects of potential disease-modifying agents and adverse effects of devices intended to ameliorate osteoarthritis elsewhere in the lower extremity. Current methods require proprietary software or have not been well validated; our purpose was to develop and assess the reliability of a digital joint space width quantification method using public access software. We studied 95 patients, asymptomatic in the ankles and without history of ankle trauma, but with symptomatic medial knee osteoarthritis, participating in an ongoing longitudinal trial. Weightbearing anteroposterior radiographs of the ankle and supine radiographs of the pelvis were assessed, and the narrowest medial and lateral tibiotalar joint space widths and hip joint space widths were measured using Image J software (US NIH, Bethesda, MD). Medial joint space widths were 2.56 +/- 0.50 and 2.55 +/- 0.48 mm, and lateral joint space widths were 2.45 +/- 0.55 and 2.44 +/- 0.52 mm, for right and left ankle, respectively. Coefficients of variation for repeat measurements by the same observer were 1.13% and 4.5%, and by different observers 7.30% and 7.27%, for medial and lateral joint space widths, respectively. Men had wider joint space widths than women when accounting for height. Joint space width of the ankle correlated with the joint space width of the hip and with height and weight, but not with age.
| S-EPMC2706360 | biostudies-literature
Project description:BACKGROUND:No consensus is available regarding the best method for measuring tibiofemoral joint space width (JSW) on radiographs to quantify joint changes after injury. Studies that track articular cartilage thickness after injury frequently use patients' uninjured contralateral knees as controls, although the literature supporting this comparison is limited. PURPOSE:(1) To compare JSW measurements using 2 established measurement techniques in healthy control participants and (2) to determine whether the mean JSW of the uninjured contralateral knee in a cohort with anterior cruciate ligament (ACL) reconstruction is different from that obtained from a true control population. STUDY DESIGN:Cohort study (diagnosis); Level of evidence, 2. METHODS:Medial and lateral JSWs were measured on standardized, bilateral, semiflexed metatarsophalangeal positioning, posteroanterior radiographs of 60 healthy individuals (26 females; mean ± SD age, 25 ± 6.2 years; no history of knee injury) via 2 published techniques: a computerized surface-delineation method (surface-fit method) and a manual digitization method (midpoint method). Bland-Altman method was used to examine the agreement between JSW measurements obtained with the 2 methods and to examine the agreement between measurements obtained on left and right knees within a participant for each measurement method. Within- and between-participant variance components and intraclass correlation coefficients (ICCs) were computed for JSW measurements corresponding to each method. Two-sample t tests were used to compare the surface-fit method measurements of mean JSW of the true control group (n = 60) with the previously published mean JSW measurements from the Multicenter Orthopaedics Outcomes Network (MOON) nested cohort of 262 contralateral uninjured knees 2 to 3 years after ACL reconstruction. RESULTS:For JSW in the medial compartment, the surface-fit method had lower within-participant interknee variability (?2within, 0.064; 95% CI, 0.04-0.09) compared with the midpoint method (?2within, 0.28; 95% CI, 0.20-0.43) and a higher ICC (0.93 vs 0.65; P < .001). Lateral JSW values were similar for the surface-fit method (?2within, 0.27; 95% CI, 0.18-0.43) and the midpoint method (?2within, 0.20; 95% CI, 0.14-0.31), with ICCs of 0.75 and 0.77, respectively (P = .80). With the surface-fit method, mean JSW measurements of the medial and lateral compartments of a control population were not significantly different from the contralateral uninjured knees of patients after ACL reconstruction. CONCLUSION:For measuring medial JSW, the surface-fit method was less variable across knees within a participant than the midpoint method, as evidenced by larger ICCs and lower interknee variability. For measuring lateral JSW, the 2 methods were similar. The JSW measurements of uninjured contralateral knees of patients with ACL reconstruction at 2 to 3 years postsurgery were not significantly different from those of a cohort of healthy control participants. Future work should be performed to demonstrate the validity of these methods for documenting change over time in the ACL-reconstructed knee.
| S-EPMC5624356 | biostudies-literature
Project description:Optimizing the geometric complexity of musculoskeletal models is important for reliable yet feasible estimation of joint biomechanics. This study investigated the effects of subject-specific model geometry on hip joint reaction forces (JRFs) and muscle forces in patients with developmental dysplasia of the hip (DDH) and healthy controls. For nine DDH and nine control subjects, three models were created with increasingly subject-specific pelvis geometry, hip joint center locations and muscle attachments. Hip JRFs and muscle forces during a gait cycle were compared among the models. For DDH subjects, resultant JRFs from highly specific models including subject-specific pelvis geometry, joint locations and muscle attachments were not significantly different compared to models using generic geometry in early stance, but were significantly higher in late stance (p = 0.03). Estimates from moderately specific models using CT-informed scaling of generic pelvis geometry were not significantly different from low specificity models using generic geometry scaled with skin markers. For controls, resultant JRFs in early stance from highly specific models were significantly lower than moderate and low specificity models (p ≤ 0.02) with no significant differences in late stance. Inter-model JRF differences were larger for DDH subjects than controls. Inter-model differences for JRF components and muscle forces were similar to resultant JRFs. Incorporating subject-specific pelvis geometry significantly affects JRF and muscle force estimates in both DDH and control groups, which may be especially important for reliable estimation of pathomechanics in dysplastic hips.
| S-EPMC6478547 | biostudies-literature
Project description:Acetabular dysplasia is a known cause of hip osteoarthritis. In addition to abnormal anatomy, changes in kinematics, joint reaction forces (JRFs), and muscle forces could cause tissue damage to the cartilage and labrum, and may contribute to pain and fatigue. The objective of this study was to compare lower extremity joint angles, moments, hip JRFs and muscle forces during gait between patients with symptomatic acetabular dysplasia and healthy controls. Marker trajectories and ground reaction forces were measured in 10 dysplasia patients and 10 typically developing control subjects. A musculoskeletal model was scaled in OpenSim to each subject and subject-specific hip joint centers were determined using reconstructions from CT images. Joint kinematics and moments were calculated using inverse kinematics and inverse dynamics, respectively. Muscle forces and hip JRFs were estimated with static optimization. Inter-group differences were tested for statistical significance (p?0.05) and large effect sizes (d?0.8). Results demonstrated that dysplasia patients had higher medially directed JRFs. Joint angles and moments were mostly similar between the groups, but large inter-group effect sizes suggested some restriction in range of motion by patients at the hip and ankle. Higher medially-directed JRFs and inter-group differences in hip muscle forces likely stem from lateralization of the hip joint center in dysplastic patients. Joint force differences, combined with reductions in range of motion at the hip and ankle may also indicate compensatory strategies by patients with dysplasia to maintain joint stability.
| S-EPMC5939935 | biostudies-literature
Project description:OBJECTIVE:To explore to what extent three-dimensional measures of the meniscus and femorotibial cartilage explain the variation in medial and lateral femorotibial radiographic joint space width (JSW), in healthy men and women. METHODS:The right knees of 87 Osteoarthritis Initiative healthy reference participants (no symptoms, radiographic signs or risk factors of osteoarthritis; 37 men, 50 women; age 55.0±7.6; BMI 24.4±3.1) were assessed. Quantitative measures of subregional femorotibial cartilage thickness and meniscal position and morphology were computed from segmented magnetic resonance images. Minimal and medial/lateral fixed-location JSW were determined from fixed-flexion radiographs. Correlation and regression analyses were used to explore the contribution of demographic, cartilage and meniscal parameters to JSW in healthy subjects. RESULTS:The correlation with (medial) minimal JSW was somewhat stronger for cartilage thickness (0.54?r?0.67) than for meniscal (-0.31?r?0.50) or demographic measures (-0.15?r?0.48), in particular in men. In women, in contrast, the strength of the correlations of cartilage thickness and meniscal measures with minimal JSW were in the same range. Fixed-location JSW measures showed stronger correlations with cartilage thickness (r?0.68 medially; r?0.59 laterally) than with meniscal measures (r?|0.32| medially; r?|0.32| laterally). Stepwise regression models revealed that meniscal measures added significant independent information to the total variance explained in minimal JSW (adjusted multiple r2=58%) but not in medial or lateral fixed-location JSW (r2=60/51%, respectively). CONCLUSIONS:In healthy subjects, minimal JSW was observed to reflect a combination of cartilage and meniscal measures, particularly in women. Fixed-location JSW, in contrast, was found to be dominated by variance in cartilage thickness in both men and women, with somewhat higher correlations between cartilage and JSW in the medial than lateral femorotibial compartment. The significant contribution of the meniscus' position on minimal JSW reinforces concerns over validity of JSW as an indirect measure of hyaline cartilage.
| S-EPMC5278117 | biostudies-literature
Project description:BackgroundShoulder arthroscopy can be performed with the patient in the lateral decubitus or beach-chair position, but in both cases, glenohumeral (GH) joint spaces must be increased to improve visualization and allow access of the optical instrument. The aim of this study was to determine the effects of limb setup and longitudinal traction on the opening of the GH space with patients placed in the beach-chair (dorsal decubitus) position.MethodsGH spaces at 3 test points corresponding to the anatomic locations of Bankart lesions were determined indirectly from radiographic images obtained from 67 patients presenting shoulder pathology with an indication for arthroscopic surgery. Measurements were made with the operative limb in neutral rotation and positioned in relation to the coronal plane in adduction, 45° of abduction, or adduction with an axillary spacer, in each case with and without longitudinal traction.ResultsGH spaces were optimized at 2 of 3 test points when the operative limb was positioned in adduction or neutral rotation and manual longitudinal traction was applied with or without a polystyrene spacer placed under the axilla, but use of the spacer was essential to maximize the GH space at all 3 locations. In contrast, 45° of abduction proved to be the least appropriate position because it afforded the smallest GH space values with or without traction.ConclusionAppropriate positioning of the patient on the operating table is a critical aspect of shoulder arthroscopy. Radiographic images revealed that adducted upper-limb traction with the use of an axillary spacer in patients in the beach-chair position generates a significant increase in the GH space in the lower half of the glenoid cavity, thereby facilitating visualization and access of the optical equipment to the GH compartments.
| S-EPMC7075773 | biostudies-literature
Project description:To study fully automated digital joint space width (JSW) and bone mineral density (BMD) in relation to a conventional radiographic scoring method in early rheumatoid arthritis (eRA).Radiographs scored by the modified Sharp van der Heijde score (SHS) in patients with eRA were acquired from the SWEdish FarmacOTherapy study. Fully automated JSW measurements of bilateral metacarpals 2, 3 and 4 were compared with the joint space narrowing (JSN) score in SHS. Multilevel mixed model statistics were applied to calculate the significance of the association between ?JSW and ?BMD over 1?year, and the JSW differences between damaged and undamaged joints as evaluated by the JSN.Based on 576 joints of 96 patients with eRA, a significant reduction from baseline to 1?year was observed in the JSW from 1.69 (±0.19) mm to 1.66 (±0.19) mm (p<0.01),?and BMD from 0.583 (±0.068) g/cm2 to 0.566 (±0.074) g/cm2 (p<0.01). A significant positive association was observed between ?JSW and ?BMD over 1?year (p<0.0001). On an individual joint level, JSWs of undamaged (JSN=0) joints were wider than damaged (JSN>0) joints: 1.68?mm (95%?CI 1.70 to 1.67) vs 1.54?mm (95%?CI 1.63 to 1.46). Similarly the unadjusted multilevel model showed significant differences in JSW between undamaged (1.68?mm (95%?CI 1.72 to 1.64)) and damaged joints (1.63?mm (95%?CI 1.68 to 1.58)) (p=0.0048). This difference remained significant in the adjusted model: 1.66?mm (95%?CI 1.70 to 1.61) vs 1.62?mm (95%?CI 1.68 to 1.56) (p=0.042).To measure the JSW with this fully automated digital tool may be useful as a quick and observer-independent application for evaluating cartilage damage in eRA.NCT00764725.
| S-EPMC5574453 | biostudies-literature
Project description:UNLABELLED: Acetabular bone loss hampers implantation of a total hip arthroplasty in patients with developmental dysplasia of the hip. The bone impaction grafting technique in combination with a cemented total hip can restore the bone stock in these patients, but do these reconstructions yield satisfying long-term results? We used this technique in 28 hips (22 consecutive patients). The degree of dislocation was graded preoperatively as Crowe I in five hips, Crowe II in eight hips, Crowe III in nine hips, and Crowe IV in four hips. We present the long-term results of this bone impaction grafting technique a minimum of 10 years after surgery. Two patients died before the minimum followup of 10 years, leaving 20 patients (26 hips). Two cups were revised, one cup for a sciatic nerve palsy (at 2 years) and the other for aseptic loosening after 12 years. The cumulative survival of the cup with revision for any reason as the end point was 96% at 10 years and 84% at 15 years. There were no femoral revisions during followup. The bone impaction grafting technique in combination with a cemented cup is an effective technique for developmental dysplasia of the hip with favorable long-term results. LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
| S-EPMC2505129 | biostudies-other
Project description:BackgroundIt has been hypothesized that quadriceps muscle weakness is directly associated with the onset and progression of posttraumatic osteoarthritis after anterior cruciate ligament (ACL) injury and reconstruction (ACLR). This relationship, however, has not been studied with a prospective approach that includes the use of tibiofemoral joint space width difference (JSW-D) measurements to characterize the onset of posttraumatic osteoarthritis before the clinical manifestation of the disease.PurposeTo assess the relationship between thigh muscle strength and JSW-D at presurgery baseline and at 1- and 4-year follow-up after ACLR compared with healthy, noninjured participants of similar sex, age, body mass index, and activity level.Study designCohort study; Level of evidence, 3.MethodsA total of 39 unilateral ACL-injured patients and 32 healthy controls were followed prospectively. During each follow-up, JSW, isokinetic knee strength, single-legged hop, and clinical- and patient-oriented outcomes were assessed. At final follow-up, ACL-injured participants who had JSW-D values (considered as the injured minus normal knee) that were less than the 95% confidence interval of controls were considered to be in the ACLR-narrow group, while those with JSW-D values that fell within the confidence intervals were in the ACLR-normal group. Relationships were evaluated between ACLR groups and controls via multilevel regression, as well as Kruskal-Wallis tests for between-group comparisons at 4-year follow-up.ResultsAt 4-year follow-up, 30 participants (79%) were in the ACLR-normal group and 8 (21%) were in the ACLR-narrow group. At baseline, the extension, flexion, and extension/flexion ratio strength values for both ACLR groups were significantly lower than those of controls (P ≤ .05), while the ACLR-narrow group had significantly lower extension strength at 60 and 180 deg/s (P = .04 and .03, respectively), as well as extension/flexion ratio at 60 deg/s (P = .04) in comparison with the ACL-normal group. At 4-year follow-up, 60 deg/s extension strength deficits persisted in the ACLR-narrow group compared with controls and ACLR-normal participants (P = .01 and .04, respectively). Flexion strength at 180 and 300 deg/s was also significantly lower in the ACLR-narrow group compared with ACLR-normal (P = .02 and .04, respectively), as was single-legged hop distance (P = .04).ConclusionStrength deficits present within months after ACL injury and persist through 4 years after ACLR in participants with significantly narrowed JSW-D, compared with ACLR participants with normal JSW-D and controls. This study revealed a significant relationship between quadriceps strength loss that occurred soon after injury and JSW narrowing.
| S-EPMC6604053 | biostudies-literature
Project description:BackgroundAlthough the association between femoroacetabular impingement (FAI) syndrome and hip osteoarthritis (OA) is well established, not all hips exhibiting cam or pincer morphologies (i.e. imaging findings of FAI syndrome) are symptomatic or arthritic. It is difficult to detect which subgroup will wear out, or how does the arthritic process start radiographically. Therefore, we measured in a retrospective study based on computed tomography (CT) analysis, the joint space width (JSW) according to a standard protocol and we investigated its variation according to the presence of a cam and/or pincer morphology. We hypothesized that the radiological presence of a cam and/or pincer hip morphologies, even in asymptomatic subjects, would affect JSW.MethodsTwo hundred pelvic CT scans performed for non-orthopedic etiologies in asymptomatic patients were analyzed using a 3D software. After excluding patients with hip OA or previous hip surgery, 194 pelvic CT scans (388 hips) were retained. We measured for each hip the presence of FAI syndrome imaging findings (cam and pincer morphologies) using the classical parameters of coxometry. In addition, we performed a measurement of articular joint space width according to a standard protocol. We then calculated the mean thickness of 3 defined regions along the femoroacetabular joint: anterior-superior, posterior-inferior, and posterior-superior. Lastly, we compared the JSW across 4 groups: hips with (1) no cam or pincer, (2) pincer, (3) cam, and (4) cam and pincer morphologies using a multivariate analysis. Additionally, a topographic heatmap of JSW was plotted allowing quantitative representation of JSW along the joint.ResultsIncreased JSW with peak difference of 0.9 mm (25.7%) was found in hips with cam and pincer morphologies when compared to normal ones (p = 0.002) and to hips with pincer or cam morphologies only.ConclusionPositive variations in JSW were associated to the presence of cam and pincer morphologies. This significant increase in JSW could be one of the earliest measurable changes preceding later classical alterations.
| S-EPMC7844437 | biostudies-literature