X-ray alignment and its link to knee pain and fear of movement in knee osteoarthritis

The Effect of Radiographically Evaluated Anatomical Axis on Pain and Kinesiophobia in Knee Osteoarthritis

Observational Istanbul Physical Medicine Rehabilitation Training and Research Hospital · NCT07168590

This will test whether the leg alignment seen on a knee X-ray is linked to pain, function, quality of life, and fear of movement in adults with knee osteoarthritis.

Quick facts

Study typeObservational
Enrollment100 (estimated)
Ages18 Years and up
SexAll
SponsorIstanbul Physical Medicine Rehabilitation Training and Research Hospital Government
Locations1 site (Istanbul)
Trial IDNCT07168590 on ClinicalTrials.gov

What this trial studies

This single-center, cross-sectional study will enroll about 100 adults with clinically and radiographically confirmed knee osteoarthritis who have an anteroposterior knee X-ray taken within the past six months. Researchers will measure the anatomical axis (varus/valgus alignment) on standard knee X-rays and collect patient-reported outcomes including pain (VAS), function (WOMAC), quality of life (SF-36), and kinesiophobia (Tampa Scale for Kinesiophobia). Participants with prior knee surgery, inability to walk, illiteracy, or refusal will be excluded, and data collection occurs at the outpatient Physical Medicine and Rehabilitation clinic in Istanbul. The study uses cross-sectional correlation and subgroup analyses to see if radiographic alignment patterns are associated with worse symptoms or higher fear of movement.

Who should consider this trial

Good fit: Adults with clinical and radiographic knee osteoarthritis who have an AP knee X-ray from the past six months, can understand questionnaires, and can attend the Istanbul outpatient clinic.

Not a fit: Patients with prior knee surgery, joint prostheses, inability to walk, illiteracy, refusal to participate, or without a recent AP knee X-ray are unlikely to be included or to benefit from the study findings.

Why it matters

Potential benefit: If alignment is linked to worse pain or kinesiophobia, clinicians could use routine knee X-rays to identify patients who might benefit from targeted alignment-correcting treatments or tailored rehabilitation.

How similar studies have performed: Previous studies have linked varus or valgus malalignment to increased structural damage and pain in knee osteoarthritis, but few have simultaneously examined alignment alongside quality of life and kinesiophobia, so the approach is partly supported but somewhat novel.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Diagnosis of knee osteoarthritis (clinical and radiographic)
* Having an anteroposterior knee X-ray taken within the last 6 months
* Voluntary agreement to participate in the study
* Cognitive ability sufficient to understand test instructions

Exclusion Criteria:

* History of knee surgery
* Illiteracy (inability to read/write)
* Refusal to participate
* Presence of orthopedic conditions that prevent walking (e.g., amputation, joint prosthesis)

Where this trial is running

Istanbul

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Knee OsteoarthritisPainKinesiophobiaKnee osteoarthritisAnatomical axisRadiographic alignmentTampa Scale for KinesiophobiaSF-36
Last reviewed 2026-06-10 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.