We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Reliability of Angle Measurements Based on the Epiphyseal Scar for Knee Osteotomy: An International Multicenter Radiographic Study.
- Authors
Schippers, Philipp; Peras, Matthieu; de Geofroy, Bernard; Drees, Philipp; Gercek, Erol; Junker, Marius; Micicoi, Lolita; Gonzalez, Jean-François; Micicoi, Grégoire
- Abstract
Background: The proximal tibial epiphyseal inclination can be used as a prognostic factor for good results after knee osteotomy and measured using the tibial bone varus angle (TBVA). This angle depends on the visibility of the epiphyseal plate, which has shown poor reproducibility when measured on standard radiographs by conventional methods. Purpose: To evaluate the measurement reliability of the TBVA and other angles based on the epiphyseal scar using a digital image display. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: A total of 100 whole-leg radiographs were analyzed twice by 3 orthopaedic surgeons from 2 countries in a blinded and randomized manner. Observers measured the hip-knee-ankle angle, mechanical lateral distal femoral angle, medial proximal tibial angle, and TBVA. The growth plate–tibial plateau (GPTP) angle, defined as the angle between the epiphyseal scar and tibial plateau, was measured; this angle has not yet been described for osteotomy. In addition, a modified version of the TBVA (mTBVA), defined as that between the epiphyseal scar, its center, and the center of the talus, was measured. The Ahlbäck score for osteoarthritis and a 3-grade score for epiphyseal scar visibility were also determined. The reliability of the angle measurements and scoring was evaluated using the Fleiss kappa and intraclass correlation coefficient (ICC). Results: The scores for epiphyseal scar visibility showed fair interobserver (Fleiss kappa correlation coefficient [κ] = 0.29-0.35) and strong intraobserver (Fleiss κ = 0.62-0.69) reliability. TBVA, GPTP angle, and mTBVA measurements showed good interobserver reliability (ICC, 0.76-0.77), while the GPTP angle achieved excellent intraobserver reliability (ICC, >0.9). Conclusion: Using digital image display, angles that depend on the epiphyseal scar—such as TBVA, GPTP angle, and mTBVA—can achieve acceptable measurement reliability despite the low agreement on the visibility of the epiphyseal scar.
- Subjects
LEG radiography; STATISTICAL correlation; LEG; BODY mass index; RESEARCH evaluation; DESCRIPTIVE statistics; OSTEOTOMY; LONGITUDINAL method; EPIPHYSIS; STATISTICS; DATA analysis software; CONFIDENCE intervals; KNEE surgery; INTER-observer reliability; EVALUATION
- Publication
Orthopaedic Journal of Sports Medicine, 2024, Vol 12, Issue 7, p1
- ISSN
2325-9671
- Publication type
Article
- DOI
10.1177/23259671241252812