Journal article
Interobserver agreement in the classification of rotator cuff tears
The American journal of sports medicine, Vol.35(3), pp.437-441
2007
DOI: 10.1177/0363546506298108
PMID: 17267769
Abstract
Background: Six classification systems have been proposed for describing rotator cuff tears designed to help understand their natural history and make treatment decisions.
Purpose: To assess the interobserver variation for these classification systems and identify the method with the best interobserver agreement.
Study design: Cohort study (diagnosis); Level of evidence, 2.
Methods: Six rotator cuff tear classification systems were identified in a literature search. The components of these systems included partial-thickness rotator cuff tears and classification by size, shape, configuration, number of tendons involved, and by extent, topography, and nature of the biceps. Twelve fellowship-trained orthopaedic surgeons who each perform at least 30 rotator cuff repairs per year reviewed arthroscopy videos from 30 patients with a random assortment of rotator cuff tears and classified them by the 6 classification systems. Interobserver variation was determined by a kappa analysis.
Results: Interobserver agreement was high when distinguishing between full-thickness and partial-thickness tears (0.95, kappa = 0.85). The investigators agreed on the side (articular vs bursal) of involvement for partial-thickness tears (observed agreement 0.92, kappa = 0.85) but could not agree when classifying the depth of the partial-thickness tear (observed agreement 0.49, kappa = 0.19). The best agreement for full-thickness tears was seen when the tear was classified by topography (degree of retraction) in the frontal plane (observed agreement 0.70, kappa = 0.54).
Conclusion: With the exception of distinguishing partial-thickness from full-thickness rotator cuff tears and identifying the side (articular vs bursal) of involvement with partial-thickness tears, currently described rotator cuff classification systems have little interobserver agreement among experienced shoulder surgeons. Researchers should consider describing full-thickness rotator cuff tears by topography (degree of retraction) in the frontal plane.
Details
- Title: Subtitle
- Interobserver agreement in the classification of rotator cuff tears
- Creators
- John E KUHN - Division of Sports Medicine and Shoulder Surgery, Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee, United StatesWarren R DUNN - Division of Sports Medicine and Shoulder Surgery, Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee, United StatesBrian KELLY - Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, United StatesBrian HOLLOWAY - Shoulder and Elbow Service, Knoxville Orthopaedic Clinic, Knoxville, Tennessee, United StatesBenjamin MA - Sports Medicine Program, Department of Orthopaedic Surgery, University of California, San Francisco, California, United StatesRick W WRIGHT - Sports Medicine Service, Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri, United StatesGrant JONES - Division of Sports Medicine, Department of Orthopaedic Surgery, The Ohio State University, Columbus, Ohio, United StatesEdwin E SPENCER - Shoulder and Elbow Service, Knoxville Orthopaedic Clinic, Knoxville, Tennessee, United StatesBrian WOLF - Sports Medicine Center, Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, Iowa, United StatesMarc SAFRAN - Sports Medicine Program, Department of Orthopaedic Surgery, University of California, San Francisco, California, United StatesKurt P SPINDLER - Division of Sports Medicine and Shoulder Surgery, Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee, United StatesEric MCCARTY - Division of Sports Medicine, Department of Orthopaedics, University of Colorado, Boulder, Colorado, United States
- Resource Type
- Journal article
- Publication Details
- The American journal of sports medicine, Vol.35(3), pp.437-441
- Publisher
- American Orthopaedic Society for Sports Medicine; Waltham, MA
- DOI
- 10.1177/0363546506298108
- PMID
- 17267769
- ISSN
- 0363-5465
- eISSN
- 1552-3365
- Language
- English
- Date published
- 2007
- Academic Unit
- Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science
- Record Identifier
- 9984040567902771
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