University of Oulu

Virtanen V.K.O. et al. (2019) Quantitative Assessment of Osteoarthritic Knee Instability: Comparison with Conventional Imaging Modalities. In: Lhotska L., Sukupova L., Lacković I., Ibbott G. (eds) World Congress on Medical Physics and Biomedical Engineering 2018. IFMBE Proceedings, vol 68/2. Springer, Singapore

Quantitative assessment of osteoarthritic knee instability : comparison with conventional imaging modalities

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Author: Virtanen, V.K.O.1; Thevenot, J.1; Tiulpin, A.1;
Organizations: 1Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Aapistie 5A, 90014 Oulu, Finland,
2Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: Springer Nature, 2018
Publish Date: 2019-08-06


Knee osteoarthritis (OA) is the most common musculoskeletal disorder affecting all populations. One common knee OA symptom is instability; thus its assessment could allow diagnosing and following-up of the disease without using conventional imaging techniques, such as plain radiography or magnetic resonance imaging (MRI). Knee kinematic measurements using accelerometers could provide a low-cost and non-invasive option to quantify knee instability. The aim of this study was to assess the relationships between kinematic data, instability parameters derived from the imaging techniques, goniometer-based measurements, and radiological OA stage. The right knees of 66 females (44–67 years) were examined using MRI, plain radiography, and goniometer-based angle measurement. Kellgren–Lawrence (KL) grade and the joint line convergence angle (JLCA) were determined from the radiographs. Cartilage thickness and OA score (MOAKS) were derived from the MRI. A ratio between lateral and medial cartilage thicknesses was calculated from the average thickness of segmented cartilage over the weight bearing area (MRIratio). Accelerometers attached to thigh and shank were used to record kinematic signals during a one-leg-stand test. Power of the accelerometer signals along the anatomical longitudinal axis (Pacc) was used as a measure of knee instability. Finally, Spearman’s correlations between the acquired parameters and KL grade/MOAKS scores were calculated. Leave-one-out cross-validation and logistic regression were used to discriminate OA subjects (KL ≥ 2). All the instability parameters (Pacc, JLCA and MRIratio), except the goniometer angle, showed significant correlations with KL grading (rho = 0.32–0.64, p < 0.01) and MOAKS composite score (rho = 0.35–0.56, p < 0.01). Both Pacc and JLCA showed higher areas under the ROC curve to discriminate OA (AUC = 0.76 and AUC = 0.78) than MRIratio and goniometer angle (AUC = 0.55 and AUC = 0.56). Our results demonstrate the clinical potential of kinematic knee instability measurements using low-cost accelerometers. Such approach could become a potential new tool in OA diagnostics.

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Series: IFMBE proceedings
ISSN: 1680-0737
ISSN-E: 1433-9277
ISSN-L: 1680-0737
ISBN: 978-981-10-9038-7
ISBN Print: 978-981-10-9037-0
Pages: 703 - 708
DOI: 10.1007/978-981-10-9038-7_130
Host publication: World Congress on Medical Physics and Biomedical Engineering 2018. June 3-8 2018, Prague, Czech Rebublic
Host publication editor: Lhotska, Lenka
Sukupova, Lucie
Lacković, Igor
Ibbott, Geoffrey S.
Conference: World Congress of Medical Physics and Biomedical Engineering
Type of Publication: A4 Article in conference proceedings
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Funding: The study was funded by the Finnish Funding Agency for Technology and Innovation (TEKES) and Oulu University Hospital.
Copyright information: © Springer Nature Singapore Pte Ltd. 2019. This is a post-peer-review, pre-copyedit version of an article published in World Congress on Medical Physics and Biomedical Engineering 2018. The final authenticated version is available online at: