Issın Ahmet, Öner Ali, Koçkara Nizamettin, Özcan Seçkin
Department of Orthopedics and Traumatology, Erzincan Binali Yıldırım University Mengücek Gazi Training and Research Hospital, Erzincan, Turkey.
Department of Orthopedics and Traumatology, Metin Sabancı Baltalimanı Bone Disseases Training and Research Hospital, Istanbul, Turkey.
Turk J Phys Med Rehabil. 2020 Jun 24;66(4):383-387. doi: 10.5606/tftrd.2020.4483. eCollection 2020 Dec.
This study aims to find the shortest needed time interval between two consecutive anteroposterior (AP) knee X-rays of the same patient to determine the progression of knee osteoarthritis (KOA) by a trained eye.
In this retrospective study, 2,145 AP knee X-rays of 848 primary KOA patients (331 males, 517 females; mean age 65±9 years; range, 50 to 92 years) followed-up between January 2014 and December 2017 were used. Randomly generated 1,280 pairs of knee X-rays were shown to 14 orthopedic surgeons working in the Department of Orthopedics and Traumatology, and then the physicians were asked to select the second X-ray of the same arthritis knee. The physicians completed the test twice. The patient's age, gender, time interval between two radiographs and the responses of the physicians were recorded.
Our results showed that if the time interval between the two radiographs was six months or more, the correct estimation rates increased gradually. When the time interval was 36 months and more, the ratio reached 92%. The sensitivity and specificity rate of the method was 81%, while the positive predictive value was 86%. However, interestingly, age or gender did not have any effect on this result.
In our study, X-rays taken in less than six months apart could not give additional information about the radiographic progression of KOA. To discern between the progression of KOA, we recommend that there be a 12 to 18-month interval between consecutive X-rays. The data of our study can be used for a routine algorithm to be developed for the evaluation of KOA patients.
本研究旨在找出同一患者连续两次前后位（AP）膝关节X线检查所需的最短时间间隔，以便训练有素的专业人员判断膝关节骨关节炎（KOA）的进展情况。
在这项回顾性研究中，使用了2014年1月至2017年12月期间对848例原发性KOA患者（男性331例，女性517例；平均年龄65±9岁；范围50至92岁）进行随访时拍摄的2145张AP膝关节X线片。将随机生成的1280对膝关节X线片展示给14位在骨伤科工作的骨科医生，然后要求医生选择同一患关节炎膝关节的第二次X线片。医生完成两次测试。记录患者的年龄、性别、两张X线片之间的时间间隔以及医生的回答。
我们的结果表明，如果两张X线片之间的时间间隔为6个月或更长时间，正确估计率会逐渐增加。当时间间隔为36个月及以上时，该比例达到92%。该方法的敏感性和特异性率为81%，而阳性预测值为86%。然而，有趣的是，年龄或性别对这一结果没有任何影响。
在我们的研究中，间隔不到6个月拍摄的X线片无法提供有关KOA影像学进展的额外信息。为了辨别KOA的进展情况，我们建议连续X线片之间的间隔为12至18个月。我们研究的数据可用于开发评估KOA患者的常规算法。
