Document Detail

Reliability of Tunnel Measurements and the Quadrant Method Using Fluoroscopic Radiographs After Anterior Cruciate Ligament Reconstruction.
MedLine Citation:
PMID:  22962289     Owner:  NLM     Status:  Publisher    
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.
Jaron P Sullivan; Matthew J Matava; David C Flanigan; Yubo Gao; Carla L Britton; Annunziato Amendola; ; Brian R Wolf
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-7
Journal Detail:
Title:  The American journal of sports medicine     Volume:  -     ISSN:  1552-3365     ISO Abbreviation:  Am J Sports Med     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609541     Medline TA:  Am J Sports Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Carver College of Medicine, University of Iowa, Iowa City, Iowa.
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MeSH Terms
Kurt S Spindler / ; Warren R Dunn / ; James L Carey / ; Charles L Cox / ; Jack T Andrish / ; Richard D Parker / ; Morgan H Jones / ; Robert G Marx / ; Eric C McCarty / ; Armando F Vidal / ; Michelle Wolcott / ; Rick W Wright / ; Robert H Brophy / ; Matthew V Smith / ; Christopher C Kaeding /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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