Editorial Commentary: Radiographic Measurements of Knee Joint Space Are Inadequate for Demonstrating Chondral Restoration.

Abstract

Orthopaedic advancements into the 21st century will increasingly focus on chondral restoration to either halt or reverse degenerative processes. Researchers and clinicians will need tools beyond patient-reported outcomes to measure the effectiveness of these treatment efforts. The use of joint space width (JSW) as a surrogate for chondral restoration is inadequate. At a minimum, such observations must standardize load transmission across the joint to be useful. Simple, readily available, standardized, and clinically useful measures of knee chondral restoration would facilitate and accelerate advances in the field. For now, it may be that improvement in JSW after chondral restoration could be attributable to changes in mechanical alignment of the knee and not the chondral restoration. JSW is an inadequate surrogate for chondral restoration, and anyone doing a stress radiograph of a unicompartmental degenerative knee recognizes this point.