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- Title
Predictive factors for the progression of spontaneous osteonecrosis of the knee.
- Authors
Akamatsu, Y.; Kobayashi, H.; Kusayama, Y.; Aratake, M.; Kumagai, K.; Saito, T.
- Abstract
<bold>Purpose: </bold>To assess potentially predictive factors that were evaluated 1 year after the onset of symptoms in patients with spontaneous osteonecrosis of the knee (SONK) and to determine receiver operating characteristic (ROC) curve cut-off values.<bold>Methods: </bold>Within 1 year of symptom onset, patients with SONK-selected treatment options, mainly based on severity of pain, chose either conservative treatment (n = 27 knees) or operative treatment (n = 27 knees). Knee and whole-leg radiographs, knee MRIs and bone mineral density scans of the lumbar spine, femoral neck and femoral condyles were obtained. The parameters measured were: (1) anatomical angle on whole-leg radiograph and (2) lesion size and medial meniscus extrusion on MRI.<bold>Results: </bold>The anatomical angle and lesion size in the sagittal section (depth) on MRI were markedly larger in the operative treatment group than those in the conservative treatment group. The anatomical angle and depth on MRI of SONK at Stages 1-3 were significantly different between groups, with odds ratios (95 % confidence intervals) of 1.16 (1.18-2.34) and 1.11 (1.01-1.23). One year after symptom onset, ROC curve cut-off value for anatomical angle was 180° and depth on MRI was 20 mm.<bold>Conclusion: </bold>An anatomical angle >180° and depth >20 mm on MRI were predictive factors for a poorer prognosis 1 year after symptom onset in patients with SONK. Our results on radiographs and MRI provided a predictive prognosis for patients with SONK at the initial visit to their orthopaedic surgeons.<bold>Level Of Evidence: </bold>III.
- Subjects
OSTEONECROSIS; KNEE diseases; OSTEOARTHRITIS; MAGNETIC resonance imaging; KNEE surgery; DISEASE risk factors; FEMUR; FEMUR neck; FORECASTING; KNEE; MENISCUS (Anatomy); PROGNOSIS; RADIOGRAPHY; RECEIVER operating characteristic curves; DISEASE progression
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2017, Vol 25, Issue 2, p477
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-015-3839-6