| A CT-based classification of prior ACL femoral tunnel location for planning revision ACL surgery. | |
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MedLine Citation:
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PMID: 22159522 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: The purposes of this study are to describe an ACL femoral tunnel classification system for use in planning revision ACL reconstruction based on 3-D computed tomography (CT) reconstructions and to evaluate its inter- and intra-rater reliability. METHODS: A femoral tunnel classification system was developed based on the location of the femoral tunnel relative to the lateral intercondylar ridge. The femoral tunnel was classified as Type I if it was located entirely below and posterior to the ridge as viewed from distally, Type II if it was slightly malpositioned (either vertically, anteriorly, or both), and Type III if it was significantly malpositioned. To evaluate the reproducibility of the classification system, CT scans of 27 knees were obtained from patients scheduled for revision ACL reconstruction, and 3-D reconstructions were created. Four views of the 3-D reconstruction of each femur were then obtained, and inter- and intra-observer reliability was determined following classification of the tunnels by eight observers. RESULTS: Twenty-five tunnels were classified as Type I (5 tunnels), Type II (9 tunnels), or type III (11 tunnels) by at least 5 of 8 observers, while insufficient agreement was noted to classify two tunnels. The interobserver reliability of tunnel classification as type I, II, or III yielded a κ coefficient of 0.57, while intra-observer reliability yielded a κ coefficient of 0.67. Subclassification of type II femoral tunnels into the subgroups anterior, vertical, and both was possible in four of the nine type II patients. The interobserver reliability of the complete classification system yielded a κ coefficient of 0.50, while the intra-observer reliability yielded a κ coefficient of 0.54. CONCLUSION: Classification of the location of ACL femoral tunnels utilizing 3-D reconstructions of CT data yields moderate to substantial inter- and intra-observer reliability. LEVEL OF EVIDENCE: Diagnostic Level III. |
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Authors:
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Robert A Magnussen; Pedro Debieux; Biju Benjamin; Sébastien Lustig; Guillaume Demey; Elvire Servien; Philippe Neyret |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-8 |
Journal Detail:
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Title: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Volume: - ISSN: 1433-7347 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9314730 Medline TA: Knee Surg Sports Traumatol Arthrosc Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Orthopaedic Surgery, The Ohio State University School of Medicine, 2050 Kenny Road, Columbus, OH, 45631, USA, robert.magnussen@gmail.com. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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