Reliability and Validity of the Arthroscopic International Cartilage Repair Society Classification System: Correlation With Histological Assessment of Depth
Reliability and Validity of the Arthroscopic International Cartilage Repair Society Classification System: Correlation With Histological Assessment of Depth
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DOI：
10.1016/j.arthro.2016.12.012
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发表时间：
2017-06-01
影响因子：
4.7
通讯作者：
Theodoropoulos, John
中科院分区：
文献类型：
--
作者：
Dwyer, Tim;Martin, Ryan;Theodoropoulos, John
目的：确定国际软骨修复协会（ICRS）尸体软骨病变分级系统观察者间的可靠性，比较关节镜检查和视频评估确定 ICRS 分级系统观察者内的可靠性，并将关节镜 ICRS 分级系统与病变深度的组织学分级进行比较。方法：7 名接受过专科培训的关节镜外科医生使用 ICRS 分类系统对 5 具尸体膝关节标本中的 18 个病变进行关节镜分级。 6周后将每个病变的关节镜视频发送给外科医生，以进行重复分级和确定观察者内部的可靠性。对病变进行活检，并评估软骨病变的深度。使用组内相关性计算可靠性。结果：关节镜分级的观察者间可靠性为 0.67（95% 置信区间，0.5-0.89），视频分级的观察者内可靠性为 0.8（95% 置信区间，0.67-0.9）。关节镜深度分级与组织学深度分级之间存在高度相关性（0.91）；平均而言，外科医生使用关节镜对病变进行分级，平均比组织学分级深 0.37（范围为 0-0.86）。结论：关节镜 ICRS 分类系统具有良好的观察者间和观察者内可靠性。与深度的组织学评估的高度相关性为该分类系统的有效性提供了证据。
Purpose: To determine the interobserver reliability of the International Cartilage Repair Society (ICRS) grading system of chondral lesions in cadavers, to determine the intraobserver reliability of the ICRS grading system comparing arthroscopy and video assessment, and to compare the arthroscopic ICRS grading system with histological grading of lesion depth. Methods: Eighteen lesions in 5 cadaveric knee specimens were arthroscopically graded by 7 fellowship-trained arthroscopic surgeons using the ICRS classification system. The arthroscopic video of each lesion was sent to the surgeons 6 weeks later for repeat grading and determination of intraobserver reliability. Lesions were biopsied, and the depth of the cartilage lesion was assessed. Reliability was calculated using intraclass correlations. Results: The interobserver reliability was 0.67 (95% confidence interval, 0.5-0.89) for the arthroscopic grading, and the intraobserver reliability with the video grading was 0.8 (95% confidence interval, 0.67-0.9). A high correlation was seen between the arthroscopic grading of depth and the histological grading of depth (0.91); on average, surgeons graded lesions using arthroscopy a mean of 0.37 (range, 0-0.86) deeper than the histological grade. Conclusions: The arthroscopic ICRS classification system has good interobserver and intraobserver reliability. A high correlation with histological assessment of depth provides evidence of validity for this classification system.