{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:44:23Z","timestamp":1792082663185,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study examined whether magnetic resonance imaging (MRI)\u2010based meniscal and cartilage measurements explain the percentage of mechanical axis (%MA) to a degree comparable with the joint line convergence angle (JLCA) when added to the arithmetic hip\u2013knee\u2013ankle (aHKA) angle. The association between tibial bony alignment and medial meniscal coverage across osteoarthritis (OA) severity was also assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional study included 94 knees from 89 female patients (mean age, 54.6 years; Kellgren\u2013Lawrence [KL] Grade 0\u20134). Weight\u2010bearing full\u2010leg radiographs were used to assess %MA, aHKA, the medial proximal tibial angle (MPTA) and JLCA. Three\u2010dimensional MRI measured medial meniscus coverage and cartilage thickness. Multiple regression compared the contributions of JLCA and MRI\u2010based measurements when each was added to aHKA. The MPTA\u2010by\u2010OA\u2010severity interaction was analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      MPTA was significantly correlated with the medial meniscus coverage ratio (MMCR) in knees with advanced OA (KL Grade 3\u20134;\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.404) but not with mild or no OA (KL Grade 0\u20132;\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.064), whereas the MPTA\u2010by\u2010severity interaction was not significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.116). Model A explained 67% of the %MA variance (adjusted\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.668). Adding JLCA improved model fit (Model B: adjusted\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.840). Adding MMCR and the height\u2010normalized medial\u2010to\u2010lateral cartilage thickness difference to aHKA achieved a comparable model fit (Model C: adjusted\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.841), with all predictors significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and no multicollinearity. In a combined model including aHKA, JLCA, MMCR and cartilage thickness difference, all four variables remained significantly associated with %MA (adjusted\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.864).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Bony alignment and MRI\u2010based intra\u2010articular structural measurements were associated with weight\u2010bearing mechanical axis alignment in knee OA. When added to aHKA, MRI\u2010based meniscal coverage and cartilage thickness explained %MA with a model fit comparable to that obtained by adding JLCA. Thus, MRI\u2010based measurements may add complementary structural information to conventional radiographic evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, cross\u2010sectional study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70927","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T09:06:58Z","timestamp":1791018418000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Magnetic resonance imaging\u2010based meniscal coverage and cartilage thickness are associated with mechanical axis alignment in knee osteoarthritis"],"prefix":"10.1002","volume":"13","author":[{"given":"Atsushi","family":"Sasabe","sequence":"first","affiliation":[{"name":"Center for Stem Cell and Regenerative Medicine, Institute of Science Tokyo Tokyo 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