A comparison of radiographic anatomic axis knee alignment measurements and cross- sectional associations with knee osteoarthritis L.M. Goulston, M.T.

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A comparison of radiographic anatomic axis knee alignment measurements and cross- sectional associations with knee osteoarthritis L.M. Goulston, M.T. Sanchez-Santos, S. D'Angelo, K.M. Leyland, D.J. Hart, T.D. Spector, C. Cooper, E.M. Dennison, D. Hunter, N.K. Arden Osteoarthritis and Cartilage Volume 24, Issue 4, Pages 612-622 (April 2016) DOI: 10.1016/j.joca.2015.11.009 Copyright © 2015 Terms and Conditions

Fig. 1 Derivation of cross-sectional analysis sample of 1058 knees. *Total knee replacements (TKRs) and uni-condylar knee replacements (UKR) knees excluded as AA alignment measurements unobtainable with a prosthesis in situ (n = 8 knees). ∼Excluded medical conditions: rheumatoid arthritis, lupus, psoriatic arthritis, polymyalgia rheumatica, gout, fibromyalgia, Paget's disease, polio, Parkinson's disease, multiple sclerosis, stroke, cerebral palsy or chronic inflammatory demyelinating neuropathy. ˆMissing clinical variables: age, body mass index, or presence of knee injury. Osteoarthritis and Cartilage 2016 24, 612-622DOI: (10.1016/j.joca.2015.11.009) Copyright © 2015 Terms and Conditions

Fig. 2 One-point and two-point method knee joint centre locations. Where 1P = one-point; 2P = two-point; KJC = knee joint centre; KJC1 = tibial spine base mid-point; KJC2 = tibial spine tips mid-point; KJC3 = tibial plateau centre; FAA = femoral anatomic axis; TAA = tibial anatomic axis. (a) one-point method at tibial spine base mid-point; (b) one-point method at tibial spine tips mid-point; (c) one-point method at tibial plateau centre defined by line connecting lateral and medial margins of tibial plateau (excluding marginal osteophytes); (d) two-point method using femoral notch and tibial spine base mid-point; (e) two-point method using femoral notch and tibial spine tips mid-point; (f) two-point method using femoral notch and tibial plateau centre; (g) describing one-point method; (h) describing two-point method. Osteoarthritis and Cartilage 2016 24, 612-622DOI: (10.1016/j.joca.2015.11.009) Copyright © 2015 Terms and Conditions

Fig. 3 Histograms of chosen (a) 1P KJC3 and (b) 2P KJC3 methods. Osteoarthritis and Cartilage 2016 24, 612-622DOI: (10.1016/j.joca.2015.11.009) Copyright © 2015 Terms and Conditions

Fig. 4 Cubic spline regression graphs with chosen cut-off values. (NB: please note different scales on y axes).Fig. 4aFig. 4b1P KJC32P KJC3Reader 1 (NKA): 178.0–182.5°Reader 1 (NKA): 180.5–184.5°Reader 2 (LMG): 177.5–182.5°Reader 2 (LMG): 180.5–185.5°Reader 3 (MTS): 178.0–182.0°Reader 3 (MTS): 180.0–185.5°Mean: 177.8–182.3°Mean: 180.3–185.0°Rounded to: 178.0–182.0°Rounded to: 180.0–185.0° Osteoarthritis and Cartilage 2016 24, 612-622DOI: (10.1016/j.joca.2015.11.009) Copyright © 2015 Terms and Conditions