RESUMO
OBJECTIVES: The purpose of this study was to compare the joint space width between one-leg and both-legs standing radiographs in order to diagnose a primary osteoarthritis of the knee. METHODS: Digital radiographs of 100 medial osteoarthritic knees in 50 patients were performed. The patients had undergone one-leg standing anteroposterior (AP) views by standing on the affected leg while a both-legs standing AP view was undertaken while standing on both legs. The severity of the osteoarthritis was evaluated using the joint space width and Kellgren-Lawrence (KL) radiographic classification. The t-test was used for statistical analysis. RESULTS: The mean medial joint space width found in the one-leg and in the both-legs standing view were measured at 1.8 mm and 2.4 mm, respectively (p < 0.001, 95% CI 0.5 to 0.7). 33%, 47.4% and 23.1% of the knees diagnosed with a KL grade of I, II and III in the both-legs standing views were changed to KL grade II, III and IV in the one-leg standing views, respectively. No changes for KL IV osteoarthritis diagnoses have been found between both- and one-leg standing views. CONCLUSIONS: One-leg standing radiographs better represent joint space width than both-legs standing radiographs. 32% of both-legs standing radiographs have changed the KL grading to a more severe grade than that in the one-leg standing radiographs.Cite this article: P. Pinsornsak, K. Naratrikun, S. Kanitnate, T. Sangkomkamhang. The one-leg standing radiograph: An improved technique to evaluate the severity of knee osteoarthritis. Bone Joint Res 2016;5:436-441. DOI: 10.1302/2046-3758.59.BJR-2016-0049.R1.
RESUMO
Osteoarthritis (OA) is the most prevalent form of arthritis in the elderly. This disease is characterized by breakdown and loss of articular cartilage due to genetic, mechanical and environmental factors. Although the pathophysiology of OA is not completely known, several candidate genes have been reported to be associated with OA susceptibility. We assessed the association between genetic variation in the ADAMTS14 region and knee osteoarthritis susceptibility in the Thai population. The rs4747096 SNP was genotyped by PCR-RFLP on genomic DNA extracted from peripheral blood of 108 OA patients and 119 controls. The PCR product (196 bp) was digested with BspEI. A sample with the GG genotype showed two band sizes of 158 and 38 bp, while a sample with the AA genotype showed a single band size of 196 bp. Heterozygotes with the AG genotype showed all three corresponding bands. Genotype distributions, allele frequencies and model of inheritance in patients and controls were compared. In females, the frequency of the AA genotype and the A allele were significantly higher in knee OA patients than in controls [odds ratio (OR) = 2.79, 95% confidence interval (CI) = 1.05-7.59 and OR = 1.58, 95%CI = 1.00-2.45, respectively]. Moreover, genotypic AA and AG were associated with significantly increased risk for knee OA when compared to GG (OR = 2.72, 95%CI = 1.10-6.87). No significant associations were observed in males. In conclusion, the nsSNP rs4747096 in ADAMTS14 was associated with knee OA in female Thai patients; therefore, the role of ADAMTS14 in OA seems to be gender-dependent.