O Gastaud1, J L Raynier2, F Duparc3, L Baverel4, K Andrieu5, N Tarissi6, J Barth4. 1. Institut universitaire de l'appareil locomoteur et du sport, CHU de Nice-Pasteur 2, 30, voie Romaine, CS 51069, 06001 Nice, France. Electronic address: ogastaud.pro@gmail.com. 2. Institut universitaire de l'appareil locomoteur et du sport, CHU de Nice-Pasteur 2, 30, voie Romaine, CS 51069, 06001 Nice, France. 3. Clinique chirurgicale orthopédique et traumatologique, hôpital Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France. 4. Clinique des Cèdres, 21, rue Albert-Londres, 38432 Échirolles, France. 5. Institut universitaire de l'appareil locomoteur et du sport, CHU de Nice-Pasteur 2, 30, voie Romaine, CS 51069, 06001 Nice, France; Clinique chirurgicale orthopédique et traumatologique, hôpital Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France; Clinique des Cèdres, 21, rue Albert-Londres, 38432 Échirolles, France. 6. CHU de Rouen, hôpitaux de Rouen, 1, rue de Germont, 76031 Rouen, France.
Abstract
INTRODUCTION: The treatment of acromioclavicular (AC) joint separations is controversial, particularly for Rockwood type III injuries. Rockwood type IV injuries, which correspond to horizontal instability, are very likely under-diagnosed. The objective of this study was to evaluate the inter- and intra-observer reproducibility of the Rockwood classification through an evaluation of standard radiographs, as described in the original article. MATERIAL AND METHODS: This was a prospective radiographic study using protocol-based data from the 2014 symposium of the French Society of Arthroscopy (SFA). Fifteen anonymized radiological records were analysed by six independent examiners on two occasions, 1 week apart. The records consisted of a comparative A/P view of the two acromioclavicular joints (Zanca view), an axillary lateral view and dynamic lateral views (Tauber protocol) to uncover dynamic horizontal instability. A detailed analysis protocol was implemented that included absolute and relative measurements on each view; the relative measurements were used to account for radiographic magnification. RESULTS: The inter- and intra-observer reproducibility on the A/P radiographs was good to excellent. The reproducibility was fair to good on the lateral views, but the measurements varied greatly from one subject to another, and significant errors were found with certain records. The reproducibility of the dynamic views proposed by Tauber was poor to fair. DISCUSSION: Radiographic analysis of AC joint separations is reproducible in the vertical plane, which makes it possible to diagnose Rockwood type II, III and V injuries. On the other hand, static and dynamic analyses in the horizontal plane do not have good reproducibility and do not contribute to make an accurate diagnosis of Rockwood type IV injuries. LEVEL OF EVIDENCE: Level I, Diagnostic study.
INTRODUCTION: The treatment of acromioclavicular (AC) joint separations is controversial, particularly for Rockwood type III injuries. Rockwood type IV injuries, which correspond to horizontal instability, are very likely under-diagnosed. The objective of this study was to evaluate the inter- and intra-observer reproducibility of the Rockwood classification through an evaluation of standard radiographs, as described in the original article. MATERIAL AND METHODS: This was a prospective radiographic study using protocol-based data from the 2014 symposium of the French Society of Arthroscopy (SFA). Fifteen anonymized radiological records were analysed by six independent examiners on two occasions, 1 week apart. The records consisted of a comparative A/P view of the two acromioclavicular joints (Zanca view), an axillary lateral view and dynamic lateral views (Tauber protocol) to uncover dynamic horizontal instability. A detailed analysis protocol was implemented that included absolute and relative measurements on each view; the relative measurements were used to account for radiographic magnification. RESULTS: The inter- and intra-observer reproducibility on the A/P radiographs was good to excellent. The reproducibility was fair to good on the lateral views, but the measurements varied greatly from one subject to another, and significant errors were found with certain records. The reproducibility of the dynamic views proposed by Tauber was poor to fair. DISCUSSION: Radiographic analysis of AC joint separations is reproducible in the vertical plane, which makes it possible to diagnose Rockwood type II, III and V injuries. On the other hand, static and dynamic analyses in the horizontal plane do not have good reproducibility and do not contribute to make an accurate diagnosis of Rockwood type IV injuries. LEVEL OF EVIDENCE: Level I, Diagnostic study.
Authors: Matthias A Zumstein; Philippe Schiessl; Benedikt Ambuehl; Lilianna Bolliger; Johannes Weihs; Martin H Maurer; Beat K Moor; Michael Schaer; Sumit Raniga Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-05-25 Impact factor: 4.342
Authors: Marco-Christopher Rupp; Pavel M Kadantsev; Sebastian Siebenlist; Maximilian Hinz; Matthias J Feucht; Jonas Pogorzelski; Bastian Scheiderer; Andreas B Imhoff; Lukas N Muench; Daniel P Berthold Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-04-22 Impact factor: 4.114
Authors: Jonas Pogorzelski; Knut Beitzel; Francesco Ranuccio; Klaus Wörtler; Andreas B Imhoff; Peter J Millett; Sepp Braun Journal: BMC Musculoskelet Disord Date: 2017-12-08 Impact factor: 2.362