Radiographic grading for knee osteoarthritis. A revised scheme that relates to alignment and deformity

Objective. To develop a radiographic grading scheme for osteoarthritis of t he knee that would relate to arthritic progression and deformity. Methods, The scheme of Scott, et al was revised to include new fields of Ti bial Erosion and Subluxation; the fields of Tibial Osteophytes and Sclerosi s were removed. The worst affected compartment only was scored on frontal S tandardized Knee Images, which were used to define knee alignment variables (9). Results, The interreader reliability (K = 0.92) and correlation for total s cores (r = 0.94) were both excellent (p < 0.001). Individual field scores a nd total knee scores both correlated well with most limb alignment variable s, especially the hip-knee-ankle angle (r = 0.77, p < 0.001). Conclusion. These findings encourage further evaluations for outcome measur ement, diagnostic sensitivity, and sensitivity to define arthritic change o ver time.