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Background <p>Osteoarthritis (OA) is a degenerative joint disease that frequently affects the knee, particularly in older adults. Asymptomatic atherosclerosis (AS) in femoral and popliteal arteries may complicate surgical outcomes in patients undergoing total knee arthroplasty (TKA). (A narrative review. <i>Arthroplasty,</i> <i>4</i>(1), 11). This study aimed to assess the prevalence of AS in advanced knee OA and evaluate the role of Doppler ultrasonography in preoperative vascular risk assessment.</p> Methods <p>This cross-sectional study included 121 patients over 40 years of age with Kellgren-Lawrence grade III and IV knee OA. Bilateral Doppler ultrasonography was performed to measure peak systolic velocity (PSV) in the common femoral and popliteal arteries. Thresholds of 120 cm/sec (femoral) and 80 cm/sec (popliteal) were considered significant for stenosis. Correlation analyses were performed between Doppler parameters and clinical factors including BMI, symptom duration, and comorbidities.</p> Results <p>The prevalence of asymptomatic AS was 34.7% in the femoral artery and 36.6% in the popliteal artery. Abnormal waveforms were observed in 22.7% of femoral and 13.6% of popliteal arteries. PSV values correlated significantly with KL grade (femoral r = 0.513, popliteal r = 0.468, p 0.001) and with clinical risk factors such as higher BMI, longer symptom duration, hypertension, and smoking. ROC analysis showed high discriminatory power of PSV values for predicting OA severity.</p> Conclusions <p>A high prevalence of asymptomatic AS was observed in patients with advanced knee OA. Doppler ultrasonography proved effective in identifying vascular risk factors, suggesting its value in preoperative planning for TKA. Incorporating vascular screening, particularly in patients with high BMI, smoking, or hypertension, may reduce postoperative complications. Further studies with gold goldstandard imaging validation are recommended.</p>

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Prevalence of Atherosclerosis in Femoral and Popliteal Arteries in Advanced Osteoarthritis Knee: A Cross Sectional Ultrasound Study

  • 期刊论文

  • 发表日期：

    2025年12月22日

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  • Sunit Vardhan,
  • Sachin Kanwar,
  • Rahul Karn,
  • Aritra Chattopadhyay,
  • Kshitij Gupta,
  • Utsav Anand,
  • Pankaj Sharma,
  • Roop Bhusan Kalia

摘要

Background

Osteoarthritis (OA) is a degenerative joint disease that frequently affects the knee, particularly in older adults. Asymptomatic atherosclerosis (AS) in femoral and popliteal arteries may complicate surgical outcomes in patients undergoing total knee arthroplasty (TKA). (A narrative review. Arthroplasty, 4(1), 11). This study aimed to assess the prevalence of AS in advanced knee OA and evaluate the role of Doppler ultrasonography in preoperative vascular risk assessment.

Methods

This cross-sectional study included 121 patients over 40 years of age with Kellgren-Lawrence grade III and IV knee OA. Bilateral Doppler ultrasonography was performed to measure peak systolic velocity (PSV) in the common femoral and popliteal arteries. Thresholds of 120 cm/sec (femoral) and 80 cm/sec (popliteal) were considered significant for stenosis. Correlation analyses were performed between Doppler parameters and clinical factors including BMI, symptom duration, and comorbidities.

Results

The prevalence of asymptomatic AS was 34.7% in the femoral artery and 36.6% in the popliteal artery. Abnormal waveforms were observed in 22.7% of femoral and 13.6% of popliteal arteries. PSV values correlated significantly with KL grade (femoral r = 0.513, popliteal r = 0.468, p 0.001) and with clinical risk factors such as higher BMI, longer symptom duration, hypertension, and smoking. ROC analysis showed high discriminatory power of PSV values for predicting OA severity.

Conclusions

A high prevalence of asymptomatic AS was observed in patients with advanced knee OA. Doppler ultrasonography proved effective in identifying vascular risk factors, suggesting its value in preoperative planning for TKA. Incorporating vascular screening, particularly in patients with high BMI, smoking, or hypertension, may reduce postoperative complications. Further studies with gold goldstandard imaging validation are recommended.