The Role of Radiographic Knee Alignment in Total Knee Replacement Outcomes and Opportunities for Artificial Intelligence-Driven Assessment

Fuente: arXiv
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Main Authors: Hu, Zhisen, Cullen, Dominic, Johnson, David S., Tiulpin, Aleksei, Cootes, Timothy F., Lindner, Claudia
Format: Preprint
Published: 2025
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author Hu, Zhisen
Cullen, Dominic
Johnson, David S.
Tiulpin, Aleksei
Cootes, Timothy F.
Lindner, Claudia
author_facet Hu, Zhisen
Cullen, Dominic
Johnson, David S.
Tiulpin, Aleksei
Cootes, Timothy F.
Lindner, Claudia
contents Knee osteoarthritis (OA) is one of the most widespread and burdensome health problems [1-4]. Total knee replacement (TKR) may be offered as treatment for end-stage knee OA. Nevertheless, TKR is an invasive procedure involving prosthesis implantation at the knee joint, and around 10% of patients are dissatisfied following TKR [5,6]. Dissatisfaction is often assessed through patient-reported outcome measures (PROMs) [7], which are usually completed by patients and assessed by health professionals to evaluate the condition of TKR patients. In clinical practice, predicting poor TKR outcomes in advance could help optimise patient selection and improve management strategies. Radiographic knee alignment is an important biomarker for predicting TKR outcomes and long-term joint health. Abnormalities such as femoral or tibial deformities can directly influence surgical planning, implant selection, and postoperative recovery [8,9]. Traditional alignment measurement is manual, time-consuming, and requires long-leg radiographs, which are not always undertaken in clinical practice. Instead, standard anteroposterior (AP) knee radiographs are often the main imaging modality. Automated methods for alignment assessment in standard knee radiographs are potentially clinically valuable for improving efficiency in the knee OA treatment pathway.
format Preprint
id arxiv_https___arxiv_org_abs_2508_10941
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle The Role of Radiographic Knee Alignment in Total Knee Replacement Outcomes and Opportunities for Artificial Intelligence-Driven Assessment
Hu, Zhisen
Cullen, Dominic
Johnson, David S.
Tiulpin, Aleksei
Cootes, Timothy F.
Lindner, Claudia
Image and Video Processing
Computer Vision and Pattern Recognition
Knee osteoarthritis (OA) is one of the most widespread and burdensome health problems [1-4]. Total knee replacement (TKR) may be offered as treatment for end-stage knee OA. Nevertheless, TKR is an invasive procedure involving prosthesis implantation at the knee joint, and around 10% of patients are dissatisfied following TKR [5,6]. Dissatisfaction is often assessed through patient-reported outcome measures (PROMs) [7], which are usually completed by patients and assessed by health professionals to evaluate the condition of TKR patients. In clinical practice, predicting poor TKR outcomes in advance could help optimise patient selection and improve management strategies. Radiographic knee alignment is an important biomarker for predicting TKR outcomes and long-term joint health. Abnormalities such as femoral or tibial deformities can directly influence surgical planning, implant selection, and postoperative recovery [8,9]. Traditional alignment measurement is manual, time-consuming, and requires long-leg radiographs, which are not always undertaken in clinical practice. Instead, standard anteroposterior (AP) knee radiographs are often the main imaging modality. Automated methods for alignment assessment in standard knee radiographs are potentially clinically valuable for improving efficiency in the knee OA treatment pathway.
title The Role of Radiographic Knee Alignment in Total Knee Replacement Outcomes and Opportunities for Artificial Intelligence-Driven Assessment
topic Image and Video Processing
Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2508.10941