Cover Image

Radiographic evaluation of posttraumatic osteoarthritis of the ankle: the Kellgren–Lawrence scale is reliable and correlates with clinical symptoms

Summary Objective To assess reliability and construct validity of the Kellgren–Lawrence (K&L) scale in posttraumatic ankle osteoarthritis (OA); additionally evaluate the validity of including tibiotalar tilting in the scale. Method One-hundred and fifty ankle radiographs (75 patients, unil...

Full description

Saved in:
Bibliographic Details
Main Authors: Holzer, Nicolas, Salvo, Davide, Marijnissen, A.C.A, Vincken, K. L., Che Ahmad, Aminudin, Sierra, E., Hoffmeyer, Pierre, Stern, Richard, Lübbeke Wolff, Anne, Assal, Mathieu
Format: Article
Language:English
Published: Elsevier 2015
Subjects:
RD701 Orthopedics
Online Access:http://irep.iium.edu.my/45501/1/Holzer-2014-Radiographic_evaluation_of_posttra.pdf
http://irep.iium.edu.my/45501/
http://dx.doi.org/10.1016/j.joca.2014.11.010
Tags: Add Tag
No Tags, Be the first to tag this record!
id my.iium.irep.45501
record_format dspace
spelling my.iium.irep.455012015-11-03T07:29:41Z http://irep.iium.edu.my/45501/ Radiographic evaluation of posttraumatic osteoarthritis of the ankle: the Kellgren–Lawrence scale is reliable and correlates with clinical symptoms Holzer, Nicolas Salvo, Davide Marijnissen, A.C.A Vincken, K. L. Che Ahmad, Aminudin Sierra, E. Hoffmeyer, Pierre Stern, Richard Lübbeke Wolff, Anne Assal, Mathieu RD701 Orthopedics Summary Objective To assess reliability and construct validity of the Kellgren–Lawrence (K&L) scale in posttraumatic ankle osteoarthritis (OA); additionally evaluate the validity of including tibiotalar tilting in the scale. Method One-hundred and fifty ankle radiographs (75 patients, unilateral malleolar fractures) evaluated at average of 18 years after surgery. American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot (HF) score and pain (visual analog scale) were recorded. Grading of OA according to K&L criteria and identification of OA features was performed on standardized radiographs by four physicians. Minimal joint space width, sclerosis, and talar tilt angle were quantified by digital measurements. A modified K&L scale including talar tilting is presented. Validity of original and modified scale was evaluated and expressed as ability to (1) Identify those with clinical symptoms of ankle OA; and (2) Distinguish between different degrees of fracture severity. Results Inter- and intra-observer reliability of OA assessment according to K&L were good (ICC 0.61 and 0.75). Original and modified K&L grades significantly increased with decreasing AOFAS ankle-HF scores and greater pain. A talar-tilt angle >2° compared with ≤2° in grade 3 was associated with significantly higher pain levels (VAS pain 4.2 vs1.4, respectively; mean difference 2.8, 95% CI 0.5–5.1). More severe fracture patterns at time of surgery were more often in patients with the highest K&L grades. Conclusions The K&L scale is a valid and reliable radiographic grading system for assessment of ankle OA. Inclusion of the talar tilt angle might allow for better differentiation with respect to clinical outcomes. Elsevier 2015-03 Article REM application/pdf en http://irep.iium.edu.my/45501/1/Holzer-2014-Radiographic_evaluation_of_posttra.pdf Holzer, Nicolas and Salvo, Davide and Marijnissen, A.C.A and Vincken, K. L. and Che Ahmad, Aminudin and Sierra, E. and Hoffmeyer, Pierre and Stern, Richard and Lübbeke Wolff, Anne and Assal, Mathieu (2015) Radiographic evaluation of posttraumatic osteoarthritis of the ankle: the Kellgren–Lawrence scale is reliable and correlates with clinical symptoms. Osteoarthritis and Cartilage, 23 (3). pp. 363-369. ISSN 1063-4584 http://dx.doi.org/10.1016/j.joca.2014.11.010 10.1016/j.joca.2014.11.010
institution Universiti Islam Antarabangsa Malaysia
building IIUM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider International Islamic University Malaysia
content_source IIUM Repository (IREP)
url_provider http://irep.iium.edu.my/
language English
topic RD701 Orthopedics
spellingShingle RD701 Orthopedics
Holzer, Nicolas
Salvo, Davide
Marijnissen, A.C.A
Vincken, K. L.
Che Ahmad, Aminudin
Sierra, E.
Hoffmeyer, Pierre
Stern, Richard
Lübbeke Wolff, Anne
Assal, Mathieu
Radiographic evaluation of posttraumatic osteoarthritis of the ankle: the Kellgren–Lawrence scale is reliable and correlates with clinical symptoms
description Summary Objective To assess reliability and construct validity of the Kellgren–Lawrence (K&L) scale in posttraumatic ankle osteoarthritis (OA); additionally evaluate the validity of including tibiotalar tilting in the scale. Method One-hundred and fifty ankle radiographs (75 patients, unilateral malleolar fractures) evaluated at average of 18 years after surgery. American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot (HF) score and pain (visual analog scale) were recorded. Grading of OA according to K&L criteria and identification of OA features was performed on standardized radiographs by four physicians. Minimal joint space width, sclerosis, and talar tilt angle were quantified by digital measurements. A modified K&L scale including talar tilting is presented. Validity of original and modified scale was evaluated and expressed as ability to (1) Identify those with clinical symptoms of ankle OA; and (2) Distinguish between different degrees of fracture severity. Results Inter- and intra-observer reliability of OA assessment according to K&L were good (ICC 0.61 and 0.75). Original and modified K&L grades significantly increased with decreasing AOFAS ankle-HF scores and greater pain. A talar-tilt angle >2° compared with ≤2° in grade 3 was associated with significantly higher pain levels (VAS pain 4.2 vs1.4, respectively; mean difference 2.8, 95% CI 0.5–5.1). More severe fracture patterns at time of surgery were more often in patients with the highest K&L grades. Conclusions The K&L scale is a valid and reliable radiographic grading system for assessment of ankle OA. Inclusion of the talar tilt angle might allow for better differentiation with respect to clinical outcomes.
format Article
author Holzer, Nicolas
Salvo, Davide
Marijnissen, A.C.A
Vincken, K. L.
Che Ahmad, Aminudin
Sierra, E.
Hoffmeyer, Pierre
Stern, Richard
Lübbeke Wolff, Anne
Assal, Mathieu
author_facet Holzer, Nicolas
Salvo, Davide
Marijnissen, A.C.A
Vincken, K. L.
Che Ahmad, Aminudin
Sierra, E.
Hoffmeyer, Pierre
Stern, Richard
Lübbeke Wolff, Anne
Assal, Mathieu
author_sort Holzer, Nicolas
title Radiographic evaluation of posttraumatic osteoarthritis of the ankle: the Kellgren–Lawrence scale is reliable and correlates with clinical symptoms
title_short Radiographic evaluation of posttraumatic osteoarthritis of the ankle: the Kellgren–Lawrence scale is reliable and correlates with clinical symptoms
title_full Radiographic evaluation of posttraumatic osteoarthritis of the ankle: the Kellgren–Lawrence scale is reliable and correlates with clinical symptoms
title_fullStr Radiographic evaluation of posttraumatic osteoarthritis of the ankle: the Kellgren–Lawrence scale is reliable and correlates with clinical symptoms
title_full_unstemmed Radiographic evaluation of posttraumatic osteoarthritis of the ankle: the Kellgren–Lawrence scale is reliable and correlates with clinical symptoms
title_sort radiographic evaluation of posttraumatic osteoarthritis of the ankle: the kellgren–lawrence scale is reliable and correlates with clinical symptoms
publisher Elsevier
publishDate 2015
url http://irep.iium.edu.my/45501/1/Holzer-2014-Radiographic_evaluation_of_posttra.pdf
http://irep.iium.edu.my/45501/
http://dx.doi.org/10.1016/j.joca.2014.11.010
_version_ 1643612798291279872
score 13.211869

Similar Items