Abstract:
BACKGROUND : The aim of this study is to validate the Knee Osteoarthritis Grading System (KOGS) of
progressive osteoarthritic degeneration for the tri-compartmental knee. This system defines the site and
severity of osteoarthritis to determine a specific knee arthroplasty.
METHODS : The radiographic sequence for KOGS includes standing coronal (anteroposterior), lateral, 30
skyline patella, 15 and 45 Rosenberg and stress views in 20 of flexion. Cohen’s kappa and related
agreement statistical methods were used to assess the level of concordance of the 7 evaluators between
A and B cohorts for each evaluator and also against the actual arthroplasty used. Sensitivity and specificity
was also assessed for the KOGS in identifying true partial knee arthroplasties (PKAs) and total knee
arthroplasties (TKAs) as decided from the cohort A evaluations.
RESULTS : From a cohort of 330 patients who were included in the study, 71 (22.5%) underwent a TKA procedure,
258 (78.2%) a PKA, and 1 (0.3%) was neither a TKA nor PKA. KOGS was able to identify true PKAs
(sensitivity) in the range of 92.2%-98.5% across all the different evaluators. The KOGS method was able to
identify a PKA or a TKAwith an accuracy ranging from92% to 98.8% across all different evaluators. The surgical
results after 20 months are at least comparable with the expected average in the academic literature.
CONCLUSION : The KOGS classification provides a reliable and accurate tool to assess suitability of an individual
patient for undergoing PKA or TKA.
