Peer Review History

Original SubmissionMay 9, 2024
Decision Letter - Roham Borazjani, Editor

PONE-D-24-18391Correlation between varus-type knee osteoarthritis severity and hindfoot alignment: analysis of radiographs in the long-leg weight-bearing anteroposterior viewPLOS ONE

Dear Dr. Ozaki,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Aug 17 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org . When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

  • A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
  • A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
  • An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols . Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols .

We look forward to receiving your revised manuscript.

Kind regards,

Roham Borazjani

Academic Editor

PLOS ONE

Journal Requirements:

When submitting your revision, we need you to address these additional requirements.

1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at 

https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and 

https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: No

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: No

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you very much for allowing me to review your manuscript. I appreciate the effort you have made performing this study and submitting it to plos one. You mentioned that the present study showed a positive correlation up to grade II of K-L classification of varus-type knee OA and no positive correlation at grade III.

What about the correlation at grade 4?

In addition, with your results and conclusion, do you think you can add anything new to the science?

Reviewer #2: This manuscript contains several issues that require correction and clarification:

Abstract:

Rewrite the abstract of the article in a structured format according to the journal's guidelines.

Methodology:

Provide a detailed explanation of the study design in the methodology section.

Clearly state whether the study is retrospective or prospective, case-control or cohort, etc.

Explicitly define the inclusion and exclusion criteria for the study.

Justify why LL-WB AP view technique X-rays were taken in patients with soft tissue inflammation.

Variables:

Cite the studies that introduced the angles variables measured in this study as references.

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6. PLOS authors have the option to publish the peer review history of their article (what does this mean? ). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy .

Reviewer #1: No

Reviewer #2: Yes:  Sina Afzal

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[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/ . PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org . Please note that Supporting Information files do not need this step.

Revision 1

1. Is the manuscript technically sound, and do the data support the conclusions?

Author’s answer : Thank you for your comments. In this study, radiographs were taken at the same facility using the same equipment and under the same conditions (please see page 5). The sample sizes was based on the previous study, the references were cited as numbers 3, 4, 5 and 6 (please see page 15). The replication was based on the intraclass correlation coefficients (ICC).

2. Has the statistical analysis been performed appropriately and rigorously?

Author’s answer : Thank you for your comments. In this study, we used One-way analysis of variance (ANOVA) (please see page 8, 9).

3. Have the authors made all data underlying the findings in their manuscript fully available?

Author’s answer : Thank you for your comments. Yes. I have fully disclosed all data. I am attaching the data I used for this study.

4. Is the manuscript presented in an intelligible fashion and written in standard English?

Author’s answer : Thank you for your comments. Yes. I have reviewed and corrected the English grammar of the paper.

5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you very much for allowing me to review your manuscript. I appreciate the effort you have made performing this study and submitting it to plos one. You mentioned that the present study showed a positive correlation up to grade II of K-L classification of varus-type knee OA and no positive correlation at grade III.

What about the correlation at grade 4?

In addition, with your results and conclusion, do you think you can add anything new to the science?

Author’s answer : Thank you for your comments. In K-L classification grade IV, there was again an increase in the angle of TCA, but it cannot be judged as a positive correlation. Based on the results of TCA, we believe that valgus of the sub-talar joint may be compensatory in K-L classification grade II with the progression of KOA varus, and that the compensatory function of the sub-talar joint may not be able to keep up in cases with K-L classification grade III or higher progression.

Reviewer #2: This manuscript contains several issues that require correction and clarification:

Abstract:

Rewrite the abstract of the article in a structured format according to the journal's guidelines.

Author’s answer : Thank you for your comments. I have revised and rewritten the abstract format according to your suggestion.

Methodology:

Provide a detailed explanation of the study design in the methodology section.

Clearly state whether the study is retrospective or prospective, case-control or cohort, etc.

Author’s answer : Thank you for your comments. The study design of this research is a retrospective case-control study.

Explicitly define the inclusion and exclusion criteria for the study.

Justify why LL-WB AP view technique X-rays were taken in patients with soft tissue inflammation.

Author’s answer : Thank you for your comments. Inclusion and exclusion criteria for the study are described in the first paragraph of “Study population where you specify inclusion and exclusion criteria” (please see page 5).

The reason for performing LL-WB AP View in patients with soft tissue diseases such as anterior cruciate ligament injuries was to measure the severity of knee deformity in K-L Grade-0 patients using the same imaging method as other Grade patients.

Variables:

Cite the studies that introduced the angles variables measured in this study as references.

Author’s answer : Thank you for your comments. The references of FTA were cited as numbers 1, 23 and 24 (please see page 15, 19). The references of TAS were cited as numbers 25 and 26 (please see page 19). The references of TTW were cited as numbers 27 (please see page 19). The TCA definition and angle measurement are original angles that exist only in this study as far as I have been able to determine.

6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Author’s answer : Thank you for your comments. Yes.

Attachments
Attachment
Submitted filename: Answer for Journal Requirements 17-August-2024 Ver.2.docx
Decision Letter - Xindie Zhou, Editor

PONE-D-24-18391R1Correlation between varus-type knee osteoarthritis severity and hindfoot alignment: analysis of radiographs in the long-leg weight-bearing anteroposterior viewPLOS ONE

Dear Dr. Ozaki,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Mar 22 2025 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org . When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

  • A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
  • A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
  • An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols . Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols .

We look forward to receiving your revised manuscript.

Kind regards,

Xindie Zhou

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you very much for allowing me to review your manuscript. I appreciate the effort you have made performing this study and submitting it to plos one.

I think the authors have to mark the changes they made for revision with different color.

In addition, they did not respond to this question “ with your results and conclusion, do you think you can add anything new to the science?”

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean? ). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy .

Reviewer #1: No

**********

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/ . PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org . Please note that Supporting Information files do not need this step.

Revision 2

Response to reviewer comments

Dear Reviewers,

We would like to thank the reviewers for your time and efforts in reviewing our manuscript and for providing comments, which have considerably helped us improve our manuscript. We have made revisions based on your comments and have provided our point-by-point responses below. We hope that our responses and revisions appropriately address your comments.

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #3: I Don't Know.

Author #3: Thank you very much for allowing me to review your manuscript. I used ANOVA to assess differences between the stage and control groups in the T–T classification at the TCA, and Post-hoc analysis was performed using the Bonferroni test for multiple comparisons (please to see page 8). Based on the results of the analysis of variance, the probability of a significant difference between grade 2 and grade 3 of the K-L classification was determined to be 0.05 or less, and a significant difference was recognised. The results of the analysis of variance for TCA between each K-L classification are attached.

The variables are as follows: variable = TCA, independent variables = age/height/weight/BMI/K-L classification

K-Lgrade 0+1/2

sum of spuares degree of freedom mean spuares F-measure significance level

regression 109.798 6 18.3 1.086 0.381

residual 994.156 59 16.85

total 1103.955 65

K-Lgrade 2/3

sum of spuares degree of freedom mean spuares F-measure significance level

regression 228.129 6 38.022 2.422 0.033

residual 1302.86 83 15.697

total 1530.989 89

K-Lgrade 3/4

sum of spuares degree of freedom mean spuares F-measure significance level

regression 69.041 6 11.507 0.732 0.625

residual 1352.078 86 15.722

total 1421.118 92

6. Review Comments to the Author

Reviewer #6: Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Author #6: First of all, thank you for pointing out the corrections. I have made the corrections by adding different colors.

Next, I will answer your question. My answer is “By studying the effects of knee osteoarthritis on the talocrural joint and sub-talar joint, I believe that it has become even clearer than in previous reports that it is possible to distinguish between the limit of conservative treatment for osteoarthritis and the timing of surgical treatment intervention in order to preserve the hindfoot. This indicates the appropriate timing for both conservative and surgical treatment, and I believe that it shows the possibility of providing more appropriate treatment by reducing the disadvantages and unnecessary physical and financial burdens on patients.”.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Author response: Yes.

Best regards

Yusuke Ozaki

Orthopaedic Department, Nara Medical.University, Kashihara city, Nara prefecture, Japan

Attachments
Attachment
Submitted filename: Response to Reviewers 05-April-2025.docx
Decision Letter - Xindie Zhou, Editor

Correlation between varus-type knee osteoarthritis severity and hindfoot alignment: analysis of radiographs in the long-leg weight-bearing anteroposterior view

PONE-D-24-18391R2

Dear Dr. Ozaki,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Xindie Zhou

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Formally Accepted
Acceptance Letter - Xindie Zhou, Editor

PONE-D-24-18391R2

PLOS ONE

Dear Dr. Ozaki,

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team.

At this stage, our production department will prepare your paper for publication. This includes ensuring the following:

* All references, tables, and figures are properly cited

* All relevant supporting information is included in the manuscript submission,

* There are no issues that prevent the paper from being properly typeset

You will receive further instructions from the production team, including instructions on how to review your proof when it is ready. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few days to review your paper and let you know the next and final steps.

Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

If we can help with anything else, please email us at customercare@plos.org.

Thank you for submitting your work to PLOS ONE and supporting open access.

Kind regards,

PLOS ONE Editorial Office Staff

on behalf of

Dr. Xindie Zhou

Academic Editor

PLOS ONE

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