Summary
Objective
Radiographic joint space width (JSW) has been a standard for measuring knee osteoarthritis
(OA) structural change. Limitations in the responsiveness of this approach might be
overcome by instead measuring 3D JSW on weight-bearing CT (WBCT). This study compared
the responsiveness of 3D JSW measurements using WBCT with the responsiveness of radiographic
2D JSW.
Design
Standing, fixed-flexion knee radiographs (XR) and WBCT were acquired ancillary to
the 144- and 168-month Multicenter Osteoarthritis Study visits. Tibiofemoral JSW was
measured on both XR and WBCT. Responsiveness to change was defined by the standardized
response mean (SRM) for change in JSW (1) at predetermined mediolateral locations
(JSWx) on both modalities and (2) in the following subregions measured on WBCT images:
central medial and lateral femur (CMF/CLF) and tibia (CMT/CLT), and anterior and posterior
tibia (AMT/ALT, PMT/MLT).
Results
Baseline and 24-month follow-up JSWx measurements were completed for 265 participants
(58.1% women). Responsiveness of 3D JSWx for medial tibiofemoral compartment on coronal
WBCT (SRM range: −0.18, −0.24) exceeded that for 2D JSWx (−0.10, −0.16). Responsiveness
of 3D JSW subregional mean (−0.06, −0.36) and maximal (−1.14, −1.75) CMF and CMT and
maximal CLF/CLT 3D JSW changes were statistically significantly greater in comparison
with respective medial and lateral 2D JSWx (P ≤ 0.002).
Conclusions
Subregional 3D JSW on WBCT is substantially more responsive to 24-month changes in
tibiofemoral joint structure compared to radiographic measurements. Use of subregional
3D JSW on WBCT could enable improved detection of OA structural progression over a
24-month duration in comparison with measurements made on XR.
Keywords
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Article info
Publication history
Published online: December 13, 2022
Accepted:
December 6,
2022
Received:
May 30,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
