Reliability of early postoperative radiographic assessment of tunnel placement after anterior cruciate ligament reconstruction.
Reliability of early postoperative radiographic assessment of tunnel placement after anterior cruciate ligament reconstruction.
复制标题
前十字韧带重建后早期术后隧道放置的放射学评估的可靠性。
DOI：
10.1016/j.arthro.2011.12.010
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
MOONKneeGroup
中科院分区：
文献类型：
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作者：
Warme,BryanA;Ramme,AustinJ;Willey,MichaelC;Britton,CarlaL;Flint,JohnH;Amendola,AnnunziatoS;Wolf,BrianR;MOONKneeGroup
目的：评价前交叉韧带重建术中隧道放置的影像学评估的观察者间和观察者内的可靠性，即使是多中心骨科结局网络（MOON）组中接受过体育奖学金培训的骨科医生也参与了这项研究。我们前瞻性地纳入了54例初次前交叉韧带重建术后的连续患者。获得术后X线平片，包括膝关节完全伸展前后位视图、膝关节完全伸展位侧视图和屈曲45°时的切迹视图（Rosenberg视图）。3名设盲审查员进行了8次不同的影像学测量，包括Harner和Aglietti/Jonsson的测量。组内相关系数用于确定测量的可靠性。通过重复测量来自1个机构的20个患者图像的子集来评估评价者内可靠性，并且通过使用来自总共4个机构的所有54组电影来评估评价者间可靠性。胫骨测量的观察者内可靠性为中等至几乎完美。股骨测量的观察者间可靠性范围为轻度至中度。确定隧道深度的Harner方法比Aglietti/Jonsson方法更可靠。胫骨测量的观察者间可靠性从一般到显著不等。金属界面螺钉的存在并没有提高可靠性的measurement.CONCLUSIONSPostoperative射线照片很容易获得，但我们的研究结果表明，射线测量是相当可变的可靠性，与大多数的结果属于公平到中等categories.Level OF EvidenceLevel III，诊断研究。
PURPOSETo evaluate the interobserver and intraobserver reliability of radiographic assessment of tunnel placement in anterior cruciate ligament reconstruction.METHODSSeven sports fellowship–trained orthopaedic surgeons in the Multicenter Orthopaedic Outcomes Network (MOON) group participated in the study. We prospectively enrolled 54 consecutive patients after primary anterior cruciate ligament reconstruction. Postoperative plain radiographs were obtained including a full-extension anteroposterior view of the knee, a lateral view of the knee in full extension, and a notch view at 45° of flexion (Rosenberg view). Three blinded reviewers performed 8 different radiographic measurements including those of Harner and Aglietti/Jonsson. Intraclass correlation coefficients were used to determine reliability of the measurements. Intrarater reliability was assessed by repeated measurements of a subset of 20 patient images from 1 institution, and inter-rater reliability was assessed by use of all 54 sets of films from a total of 4 institutions.RESULTSIntraobserver reliability for femoral measures ranged from none to substantial, with notch height having the worst results. Intraobserver reliability was moderate to almost perfect for tibial measures. Interobserver reliability ranged from slight to moderate for femoral measures. The Harner method for determining tunnel depth was more reliable than the Aglietti/Jonsson method. Interobserver reliability for tibial measures ranged from fair to substantial. The presence of metal interference screws did not improve reliability of measurements.CONCLUSIONSPostoperative radiographs are easily obtained, but our results show that radiographic measurements are of quite variable reliability, with most of the results falling into the fair to moderate categories.LEVEL OF EVIDENCELevel III, diagnostic study.