Journal article
Poor Agreement on Classification and Treatment of Subscapularis Tendon Tears
Arthroscopy, Vol.32(2), pp.246-251.e1
02/2016
DOI: 10.1016/j.arthro.2015.08.006
PMID: 26432431
Abstract
To assess the inter- and intraobserver agreement for classification and management of subscapularis tendon pathology based on arthroscopy and magnetic resonance imaging (MRI).
Twenty-two orthopaedic surgeons from the Multicenter Orthopaedic Outcomes Network (MOON) shoulder group reviewed still arthroscopic and MRI images of the subscapularis tendon from patients with a random assortment of subscapularis morphology. The surgeons were asked to classify the pathology based on 2 systems (Lafosse and Lyons) and choose whether they would repair the tendon and, if so, the method of repair (open or arthroscopic). The survey was administered 3 times to each surgeon. Inter- and intraobserver reliability between testing rounds was determined by kappa analysis.
Interobserver reliability on classification of tears was poor based on MRI (k = 0.18 to 0.19) and fair based on arthroscopy (k = 0.26 to 0.29). Interobserver agreement on whether surgical treatment was indicated was fair for both MRI (k = 0.28) and arthroscopy (k = 0.38), while the agreement for type of surgery was poor based on MRI (k = 0.18) and fair based on arthroscopy (k = 0.28). Interobserver agreement did not improve when both MRI and arthroscopy were provided simultaneously (k = 0.24 to 0.30). Intraobserver reliability for classification and treatment was fair to moderate for both MRI (k = 0.32 to 0.50) and arthroscopic imaging (k = 0.39 to 0.56). When considering just those patients with normal tendons, surgeon agreement improved. For all questions, the arthroscopic images had a higher level of agreement among surgeons than the MRI (P < .001).
Although surgeons tended to have higher reliability when presented with arthroscopic images compared with MRI, there was very little agreement on the classification and management of subscapularis tendon tears.
Details
- Title: Subtitle
- Poor Agreement on Classification and Treatment of Subscapularis Tendon Tears
- Creators
- Mia Smucny - University of California, San Francisco, California, U.S.AEdward C Shin - University of California, San Francisco, California, U.S.AAlan L Zhang - University of California, San Francisco, California, U.S.ABrian T Feeley - University of California, San Francisco, California, U.S.ATatiana Gajiu - University of California, San Francisco, California, U.S.ASarah L Hall - University of California, San Francisco, California, U.S.AC Benjamin Ma - University of California, San Francisco, California, U.S.A.. Electronic address: maben@orthosurg.ucsf.eduMOON Shoulder Group (Multicenter Orthopedic Outcomes Network)
- Contributors
- Brian R Wolf (Contributor) - University of Iowa, Orthopedics and RehabilitationMatthew J Bollier (Contributor) - University of Iowa, Orthopedics and Rehabilitation
- Resource Type
- Journal article
- Publication Details
- Arthroscopy, Vol.32(2), pp.246-251.e1
- DOI
- 10.1016/j.arthro.2015.08.006
- PMID
- 26432431
- NLM abbreviation
- Arthroscopy
- ISSN
- 0749-8063
- eISSN
- 1526-3231
- Publisher
- Elsevier; United States
- Language
- English
- Date published
- 02/2016
- Academic Unit
- Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science
- Record Identifier
- 9984040445102771
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