Interrater Agreement of an Arthroscopic Anterior Cruciate Ligament Tear Classification System.
Interrater Agreement of an Arthroscopic Anterior Cruciate Ligament Tear Classification System.
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DOI：
10.1177/2325967120966323
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发表时间：
2020-12
影响因子：
2.6
通讯作者：
Spindler KP
中科院分区：
文献类型：
--
作者：
BEAR-MOON;Vega JF;Strnad GJ;Briskin I;Cox CL;Farrow LD;Fadale P;Flanigan D;Hulstyn M;Imrey PB;Kaeding CC;Owens BD;Saluan P;Wright R;Yen YM;Spindler KP
前交叉韧带（ACL）断裂是骨科医生手术治疗的最常见的韧带损伤。治疗大多数原发性ACL撕裂的金标准是ACL重建。然而，目前正在研究新的修复方法，如桥增强ACL修复（BEAR），作为重建的替代方法。为了评估患者的中间体修复适用性，阐明损伤位置和损伤的预后影响，并评价修复技术的结果，重要的是要有一个基线分类系统或分级量表，在外科医生之间是可重复的，特别是多中心合作。目前还没有这样的制度或规模。建立一个关节镜下ACL撕裂分类系统，并评价其观察者间的可靠性。队列研究（诊断）;证据等级，3。11名接受过研究员培训的整形外科医生研究者审查了75个视频剪辑，其中包含ACL撕裂的关节镜评价，然后填写了6个问题的ACL病理学评价表。然后计算一致性统计量，包括精确一致性、Fleiss κ、Gwet一致性系数1（AC1）和Gwet AC2，以评估观察者间可靠性。总体而言，观察者再现性的多重评估显示，本研究中的外科医生参与者在评价相同损伤时，大约80%的时间同意（1）至少保留50%的胫骨足迹，（2）剩余胫骨残端≥ 10 mm，（3）因此使用BEAR手术可以修复损伤。参与者还同意大约60%的时间到底有多少缝合束可用。在这些研究中，这些特征被认为是最重要的，以确定撕裂的ACL是否适合于中间物质修复。本研究首次证明了ACL撕裂关节镜分类的观察者间可靠性。我们已经证明，这种分类系统，虽然不是理想的重现性，是足够可靠的外科医生在多个机构用于多中心研究。NCT 03776162（ClinicalTrials.gov标识符）。
Anterior cruciate ligament (ACL) rupture is the most common ligament injury treated surgically by orthopaedic surgeons. The gold standard for the treatment of the majority of primary ACL tears is ACL reconstruction. However, novel methods of repair, such as bridge-enhanced ACL repair (BEAR), are currently being investigated as alternatives to reconstruction. To assess patients for midsubstance repair suitability, clarify the prognostic implications of injury location and damage, and evaluate the results of a repair technique, it is important to have a baseline classification system or grading scale that is reproducible across surgeons, particularly for multicenter collaboration. Currently, no such system or scale exists. To develop an arthroscopic ACL tear classification system and to evaluate its interobserver reliability. Cohort study (diagnosis); Level of evidence, 3. Eleven fellowship-trained orthopaedic surgeon investigators reviewed 75 video clips containing arthroscopic evaluation of a torn ACL and then completed the 6-question ACL Pathology Evaluation Form. Agreement statistics including exact agreement, Fleiss κ, Gwet agreement coefficient 1 (AC1), and Gwet AC2 were then calculated to assess interobserver reliability. In aggregate, the multiple assessments of observer reproducibility revealed that surgeon participants in this study, when evaluating the same injury, agreed roughly 80% of the time on whether (1) at least 50% of the tibial footprint remained, (2) the remaining tibial stump was ≥10 mm, and (3) the injury was therefore reparable using the BEAR procedure. Participants also agreed roughly 60% of the time on exactly how many suturable bundles were available. These characteristics are believed to be most important, among those studied, in determining whether a torn ACL is amenable to midsubstance repair. This study is the first of its kind to demonstrate the interobserver reliability of arthroscopic classification of ACL tears. We have demonstrated that this classification system, though not ideally reproducible, is reliable enough across surgeons at multiple institutions for use in multicenter studies. NCT03776162 (ClinicalTrials.gov identifier).
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DOI：
10.1177/0363546515578836
发表时间：
2015-07
期刊：
The American journal of sports medicine
影响因子：
--
作者：
Kaeding CC;Pedroza AD;Reinke EK;Huston LJ;MOON Consortium;Spindler KP
通讯作者：
Spindler KP
影响因子：
3.3
作者：
Herzog MM;Marshall SW;Lund JL;Pate V;Mack CD;Spang JT
通讯作者：
Spang JT
影响因子：
2.8
作者：
Biercevicz, Alison M.;Proffen, Benedikt L.;Murray, Martha M.;Walsh, Edward G.;Fleming, Braden C.
通讯作者：
Fleming, Braden C.
影响因子：
4.8
作者：
Dunn, WR;Wolf, BR;Spindler, KP
通讯作者：
Spindler, KP
影响因子：
1.8
作者：
Mahapatra, Piyush;Horriat, Saman;Anand, Bobby S
通讯作者：
Anand, Bobby S