Journal article
Reliability of Tunnel Measurements and the Quadrant Method Using Fluoroscopic Radiographs After Anterior Cruciate Ligament Reconstruction
The American journal of sports medicine, Vol.40(10), pp.2236-2241
2012
DOI: 10.1177/0363546512458086
PMID: 22962289
Abstract
Background:
Anterior cruciate ligament (ACL) reconstruction tunnel placement is often evaluated by radiographs. This study examines the interobserver reliability of various radiographic measurements of ACL tunnels.
Hypothesis:
When ideal radiographic views are obtained, the interobserver reliability of the measurements among experienced surgeons would be good to excellent.
Study Design:
Descriptive laboratory study.
Methods:
Tunnels for single-bundle ACL reconstruction were drilled and filled with metal interference screws or a tibial reamer on 73 cadaveric knees. Ideal fluoroscopic radiographs were obtained. Three independent reviewers performed 18 measurements including a modification of the grid method. For the grid method analysis, reviewers fit a 16 × 12 grid to the lateral knee radiograph, and the center of the femoral tunnel was marked. Interobserver reliability of the measurements was performed using intraclass correlation coefficients (ICCs). A precision grouping analysis was performed for the grid measurements to calculate the mean radius and standard deviation grouping distances.
Results:
The ICCs were excellent (>.75) for the tibial tunnel angles and tunnel measurements, the clock face measurement, and the Aglietti et al and Jonsson et al measurements. The ICCs were good (.4-.75) for an estimation of graft impingement, Harner et al measurements, and notch height. The mean radius for grid measurements was 0.6 ± 0.4 units (range, 0-2.36 units), with each unit being 1 box in the 16 × 12 grid. When a circle was constructed with a 1.3-unit radius, 95% of the 3 surgeons’ measurements would be included in the area of that circle.
Conclusion:
Reliability of ACL tunnel measurements was good to excellent under ideal circumstances for the majority of measurements. The modified grid method demonstrated very acceptable reliability.
Clinical Relevance:
Measurements with good to excellent reliability can be used to evaluate ACL tunnel placement when ideal radiographic views are obtained.
Details
- Title: Subtitle
- Reliability of Tunnel Measurements and the Quadrant Method Using Fluoroscopic Radiographs After Anterior Cruciate Ligament Reconstruction
- Creators
- Jaron P SULLIVAN - Investigation performed at University of Iowa Hospitals and Clinics, Iowa City, Iowa, United StatesMatthew J MATAVA - Investigation performed at University of Iowa Hospitals and Clinics, Iowa City, Iowa, United StatesDavid C FLANIGAN - Investigation performed at University of Iowa Hospitals and Clinics, Iowa City, Iowa, United StatesYubo Gao - Investigation performed at University of Iowa Hospitals and Clinics, Iowa City, Iowa, United StatesCarla L BRITTON - Investigation performed at University of Iowa Hospitals and Clinics, Iowa City, Iowa, United StatesAnnunziato AMENDOLA - Investigation performed at University of Iowa Hospitals and Clinics, Iowa City, Iowa, United StatesBrian R WOLF - Investigation performed at University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
- Resource Type
- Journal article
- Publication Details
- The American journal of sports medicine, Vol.40(10), pp.2236-2241
- Publisher
- Sage Publications; Thousand Oaks, CA
- DOI
- 10.1177/0363546512458086
- PMID
- 22962289
- ISSN
- 0363-5465
- eISSN
- 1552-3365
- Language
- English
- Date published
- 2012
- Academic Unit
- Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science; Internal Medicine
- Record Identifier
- 9984040307902771
Metrics
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