Validation of a novel 3-dimensional classification for degenerative arthritis of the shoulder.

Autor: Kleim BD; Department of Sports Orthopaedics, Technical University of Munich, Ismaninger Str 22, 81675, Munich, Germany. drkleim@doctors.org.uk., Lappen S; Department of Sports Orthopaedics, Technical University of Munich, Ismaninger Str 22, 81675, Munich, Germany., Kadantsev P; Department of Sports Orthopaedics, Technical University of Munich, Ismaninger Str 22, 81675, Munich, Germany., Degenhardt H; Department of Sports Orthopaedics, Technical University of Munich, Ismaninger Str 22, 81675, Munich, Germany., Fritsch L; Department of Sports Orthopaedics, Technical University of Munich, Ismaninger Str 22, 81675, Munich, Germany., Siebenlist S; Department of Sports Orthopaedics, Technical University of Munich, Ismaninger Str 22, 81675, Munich, Germany., Hinz M; Department of Sports Orthopaedics, Technical University of Munich, Ismaninger Str 22, 81675, Munich, Germany.
Jazyk: angličtina
Zdroj: Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2023 Oct; Vol. 143 (10), pp. 6159-6166. Date of Electronic Publication: 2023 Jun 12.
DOI: 10.1007/s00402-023-04890-2
Abstrakt: Introduction: A novel three-dimensional classification to comprehensively describe degenerative arthritis of the shoulder (DAS) was recently published by our group. The purpose of the present work was to investigate intra- and interobserver agreement as well as validity for the three-dimensional classification.
Materials and Methods: Preoperative computed tomography (CT) scans of 100 patients who had undergone shoulder arthroplasty for DAS were randomly selected. Four observers independently classified the CT scans twice, with an interval of 4 weeks, after prior three-dimensional reconstruction of the scapula plane using a clinical image viewing software. Shoulders were classified according to biplanar humeroscapular alignment as posterior, centered or anterior (> 20% posterior, centered, > 5% anterior subluxation of humeral head radius) and superior, centered or inferior (> 5% inferior, centered, > 20% superior subluxation of humeral head radius). Glenoid erosion was graded 1-3. Gold-standard values based on precise measurements from the primary study were used for validity calculations. Observers timed themselves during classification. Cohen's weighted κ was employed for agreement analysis.
Results: Intraobserver agreement was substantial (κ = 0.71). Interobserver agreement was moderate with a mean κ of 0.46. When the additional descriptors extra-posterior and extra-superior were included, agreement did not change substantially (κ = 0.44). When agreement for biplanar alignment alone was analyzed, κ was 0.55. The validity analysis reached moderate agreement (κ = 0.48). Observers took on average 2 min and 47 s (range 45 s to 4 min and 1 s) per CT for classification.
Conclusions: The three-dimensional classification for DAS is valid. Despite being more comprehensive, the classification shows intra- and interobserver agreement comparable to previously established classifications for DAS. Being quantifiable, this has potential for improvement with automated algorithm-based software analysis in the future. The classification can be applied in under 5 min and thus can be used in clinical practice.
(© 2023. The Author(s).)
Databáze: MEDLINE
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