International Knee Documentation Committee Radiographic Knee Joint Grading More Reliable Than Kellgren-Lawrence Grading and Other Grading Systems

Kellgren-Lawrence grading appears to have become the de facto standard for reporting radiographic degeneration of knees, yet the much later–introduced and knee-specific International Knee Documentation Committee system has repeatedly been shown to have higher reliability. Although International Knee Documentation Committee radiographic grading does have limitations—especially in cases of severe gonarthrosis—it appears to be the most reliable current system suitable for the purposes of arthroscopic knee surgeons, and it was designed to encompass all 3 knee compartments. Posterior-anterior weight-bearing radiographs taken at approximately 45° of knee flexion have repeatedly been shown to be more sensitive for revealing tibiofemoral degeneration than standard anterior-posterior weight-bearing views at or near full extension.