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Deng XT, Hu HZ, Zhu J, Chen W, Wang ZZ, Wang YC, Ye ZP, Yang SA, Zhang YZ. Associations Between Periosteal Reaction of Proximal Tibial and Medial Compartment Knee Osteoarthritis. Orthop Surg 2021; 13:1327-1335. [PMID: 33961333 PMCID: PMC8274206 DOI: 10.1111/os.12963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/18/2021] [Accepted: 01/28/2021] [Indexed: 11/30/2022] Open
Abstract
Objective To evaluate and analyze the potential relationship between periosteal reaction and medial compartment knee osteoarthritis (KOA), and to assess the independent risk factors for the development of periosteal reaction associated with medial compartment KOA. Methods This is a retrospective comparative study. From January 2019 to December 2019 at the Third Hospital of Hebei Medical University, a total of 363 patients (726 knees) with medial compartment KOA were enrolled in this study according to our inclusion and exclusion criteria, including 91 males and 272 females, with an mean age of 57.9 ± 12.8 years (range, 18–82 years). Among these patients, 206 patients (412 knees) were allocated to the periosteal reaction group (44 males and 162 females) and 157 patients (314 knees) were allocated to the non‐periosteal reaction group (47 males and 110 females). The classification of KOA severity was based on Kellgren and Lawrence (K‐L) grading system. The malalignment of the lower extremities in coronal plane was evaluated as medial proximal tibial angle (MPTA), hip‐knee‐ankle angle (HKA), and lateral distal femoral angle (LDFA). Patients demographics and radiographic parameters were recorded in the two groups. Intra‐observer and inter‐observer reliabilities of all radiological measurements were analyzed by intraclass correlation coefficients (ICCs). Univariate analyses were conducted for comparison of differences with continuous variables between patients with periosteal reaction and without periosteal reaction. Multivariate logistical regression analysis was performed to determine the independent risk factors of radiographic parameters for periosteal reaction. Results The overall incidence of periosteal reaction associated with medial compartment KOA was 56.7%. Furthermore, we observed that the incidence of periosteal reaction significantly increased with age and correlated with K‐L grade progression (P < 0.05). There was a statistically significant difference between the two groups. In the multivariate logistical regression analysis, HKA and JLCA were identified as independent risk factors of the development of periosteal reaction in patients with medial compartment KOA (odds ratio [OR], 0.594; 95% confidence interval [CI] 0.544–0.648; P < 0.05; OR, 0.851; 95% confidence interval CI 0.737–0.983; P < 0.05; respectively), with other radiographic parameters including MTPA (OR 0.959; 95% CI 0.511–0.648; P > 0.05), LDFA (OR 0.990; 95% CI 0.899–1.089; P > 0.05), and JSW (OR 1.005; 95% CI 0.865–1.167; P > 0.05). Conclusions In this retrospective study, patients with lower HKA and higher JLCA were identified as independent risk factors for the development of periosteal reaction, which occurred most commonly adjacent to the lateral of proximal tibia diaphysis, and thus we concluded that periosteal reaction may be an anatomical adaptation for medial compartment KOA based upon these results.
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Affiliation(s)
- Xiang-Tian Deng
- School of Medicine, Nankai University, Tianjin, China.,Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopeadic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
| | - Hong-Zhi Hu
- Department of Orthopedics, Union Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Jian Zhu
- School of Medicine, Nankai University, Tianjin, China.,Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopeadic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
| | - Wei Chen
- Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopeadic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
| | - Zhong-Zheng Wang
- Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopeadic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
| | - Yu-Chuan Wang
- Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopeadic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
| | - Zhi-Peng Ye
- School of Medicine, Nankai University, Tianjin, China.,Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopeadic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
| | - Sif-An Yang
- Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopeadic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
| | - Ying-Ze Zhang
- School of Medicine, Nankai University, Tianjin, China.,Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopeadic Equipment, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
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