BACKGROUND: Mechanical tests to grade cartilage damage are limited by the instruments used and by the ability to access all areas of cartilage within a joint. Better methods to diagnose cartilage injury or degeneration are needed. Purpose/ HYPOTHESIS: To detect the interobserver variance of arthroscopic cartilage grading by subjective judgment using the International Cartilage Repair Society (ICRS) score and by objective measurement using near-infrared (NIR) spectroscopy. We hypothesized that objective measurement of cartilage lesions by NIR spectroscopy will yield more valid results than routine grading using the ICRS score. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2. METHODS: Fifteen patients undergoing arthroscopic knee operations were evaluated by 4 experienced arthroscopists independently. The cartilage lesions within the medial knee compartment were estimated by each observer using the ICRS grade and by measurements with a special arthroscopic NIR spectroscopy probe. RESULTS: The ICRS grading had a poor interobserver agreement, with a mean Fleiss kappa index of κ = 0.173. Only in 10% (6 of 60) of judged cartilage areas did all 4 surgeons grade the cartilage areas with the same result. In 17 areas (28.3%), the surgeons had a variance of 2 or more grades. In the remaining cases, the surgeons varied within 1 grade. The objective NIR spectroscopy-obtained measurements of cartilage resulted in a significant correlation within the observers of R = 0.885 ± 0.036 (P < .001). CONCLUSION: Our results of interobserver evaluation in real-time arthroscopic cartilage grading suggest that this subjective grading is not satisfactory. This study emphasizes the need for objective measurement techniques for arthroscopic cartilage grading. Near-infrared spectroscopy has a good interobserver correlation. Thus, this method could be developed in the future as a precise method of measuring cartilage lesions.
BACKGROUND: Mechanical tests to grade cartilage damage are limited by the instruments used and by the ability to access all areas of cartilage within a joint. Better methods to diagnose cartilage injury or degeneration are needed. Purpose/ HYPOTHESIS: To detect the interobserver variance of arthroscopic cartilage grading by subjective judgment using the International Cartilage Repair Society (ICRS) score and by objective measurement using near-infrared (NIR) spectroscopy. We hypothesized that objective measurement of cartilage lesions by NIR spectroscopy will yield more valid results than routine grading using the ICRS score. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2. METHODS: Fifteen patients undergoing arthroscopic knee operations were evaluated by 4 experienced arthroscopists independently. The cartilage lesions within the medial knee compartment were estimated by each observer using the ICRS grade and by measurements with a special arthroscopic NIR spectroscopy probe. RESULTS: The ICRS grading had a poor interobserver agreement, with a mean Fleiss kappa index of κ = 0.173. Only in 10% (6 of 60) of judged cartilage areas did all 4 surgeons grade the cartilage areas with the same result. In 17 areas (28.3%), the surgeons had a variance of 2 or more grades. In the remaining cases, the surgeons varied within 1 grade. The objective NIR spectroscopy-obtained measurements of cartilage resulted in a significant correlation within the observers of R = 0.885 ± 0.036 (P < .001). CONCLUSION: Our results of interobserver evaluation in real-time arthroscopic cartilage grading suggest that this subjective grading is not satisfactory. This study emphasizes the need for objective measurement techniques for arthroscopic cartilage grading. Near-infrared spectroscopy has a good interobserver correlation. Thus, this method could be developed in the future as a precise method of measuring cartilage lesions.
Authors: Isaac O Afara; Rubina Shaikh; Ervin Nippolainen; William Querido; Jari Torniainen; Jaakko K Sarin; Shital Kandel; Nancy Pleshko; Juha Töyräs Journal: Nat Protoc Date: 2021-01-18 Impact factor: 13.491
Authors: Iman Kafian-Attari; Ervin Nippolainen; Dmitry Semenov; Markku Hauta-Kasari; Juha Töyräs; Isaac O Afara Journal: Biomed Opt Express Date: 2020-10-19 Impact factor: 3.732
Authors: Farzad Yousefi; Minwook Kim; Syeda Yusra Nahri; Robert L Mauck; Nancy Pleshko Journal: Tissue Eng Part A Date: 2017-05-15 Impact factor: 3.845
Authors: Stephanie Tatjana Stumpfe; Julia Karin Pester; Susanne Steinert; Ivan Marintschev; Holger Plettenberg; Matthias Aurich; Gunther Olaf Hofmann Journal: Muscles Ligaments Tendons J Date: 2013-08-11
Authors: Arash Hanifi; Xiaohong Bi; Xu Yang; Beril Kavukcuoglu; Ping Chang Lin; Edward DiCarlo; Richard G Spencer; Mathias P G Bostrom; Nancy Pleshko Journal: Am J Sports Med Date: 2012-10-29 Impact factor: 6.202