Tim Dwyer1, C Ryan Martin2, Rita Kendra3, Corey Sermer3, Jaskarndip Chahal4, Darrell Ogilvie-Harris4, Daniel Whelan4, Lucas Murnaghan4, Aaron Nauth2, John Theodoropoulos5. 1. Department of Surgery, Division of Orthopedics, University of Toronto Orthopaedic Sports Medicine, Toronto, Ontario, Canada; Women's College Hospital, Toronto, Ontario, Canada; Mt Sinai Hospital, Toronto, Ontario, Canada. Electronic address: tim.dwyer@wchospital.ca. 2. Department of Surgery, Division of Orthopedics, University of Toronto Orthopaedic Sports Medicine, Toronto, Ontario, Canada. 3. Mt Sinai Hospital, Toronto, Ontario, Canada. 4. Department of Surgery, Division of Orthopedics, University of Toronto Orthopaedic Sports Medicine, Toronto, Ontario, Canada; Women's College Hospital, Toronto, Ontario, Canada. 5. Department of Surgery, Division of Orthopedics, University of Toronto Orthopaedic Sports Medicine, Toronto, Ontario, Canada; Women's College Hospital, Toronto, Ontario, Canada; Mt Sinai Hospital, Toronto, Ontario, Canada.
Abstract
PURPOSE: To determine the interobserver reliability of the International Cartilage Repair Society (ICRS) grading system of chondral lesions in cadavers, to determine the intraobserver reliability of the ICRS grading system comparing arthroscopy and video assessment, and to compare the arthroscopic ICRS grading system with histological grading of lesion depth. METHODS: Eighteen lesions in 5 cadaveric knee specimens were arthroscopically graded by 7 fellowship-trained arthroscopic surgeons using the ICRS classification system. The arthroscopic video of each lesion was sent to the surgeons 6 weeks later for repeat grading and determination of intraobserver reliability. Lesions were biopsied, and the depth of the cartilage lesion was assessed. Reliability was calculated using intraclass correlations. RESULTS: The interobserver reliability was 0.67 (95% confidence interval, 0.5-0.89) for the arthroscopic grading, and the intraobserver reliability with the video grading was 0.8 (95% confidence interval, 0.67-0.9). A high correlation was seen between the arthroscopic grading of depth and the histological grading of depth (0.91); on average, surgeons graded lesions using arthroscopy a mean of 0.37 (range, 0-0.86) deeper than the histological grade. CONCLUSIONS: The arthroscopic ICRS classification system has good interobserver and intraobserver reliability. A high correlation with histological assessment of depth provides evidence of validity for this classification system. CLINICAL RELEVANCE: As cartilage lesions are treated on the basis of the arthroscopic ICRS classification, it is important to ascertain the reliability and validity of this method.
PURPOSE: To determine the interobserver reliability of the International Cartilage Repair Society (ICRS) grading system of chondral lesions in cadavers, to determine the intraobserver reliability of the ICRS grading system comparing arthroscopy and video assessment, and to compare the arthroscopic ICRS grading system with histological grading of lesion depth. METHODS: Eighteen lesions in 5 cadaveric knee specimens were arthroscopically graded by 7 fellowship-trained arthroscopic surgeons using the ICRS classification system. The arthroscopic video of each lesion was sent to the surgeons 6 weeks later for repeat grading and determination of intraobserver reliability. Lesions were biopsied, and the depth of the cartilage lesion was assessed. Reliability was calculated using intraclass correlations. RESULTS: The interobserver reliability was 0.67 (95% confidence interval, 0.5-0.89) for the arthroscopic grading, and the intraobserver reliability with the video grading was 0.8 (95% confidence interval, 0.67-0.9). A high correlation was seen between the arthroscopic grading of depth and the histological grading of depth (0.91); on average, surgeons graded lesions using arthroscopy a mean of 0.37 (range, 0-0.86) deeper than the histological grade. CONCLUSIONS: The arthroscopic ICRS classification system has good interobserver and intraobserver reliability. A high correlation with histological assessment of depth provides evidence of validity for this classification system. CLINICAL RELEVANCE: As cartilage lesions are treated on the basis of the arthroscopic ICRS classification, it is important to ascertain the reliability and validity of this method.
Authors: J Kristopher Ware; Brett D Owens; Matthew R Akelman; Naga Padmini Karamchedu; Paul D Fadale; Michael J Hulstyn; Robert M Shalvoy; Gary J Badger; Braden C Fleming Journal: Am J Sports Med Date: 2018-02-05 Impact factor: 6.202
Authors: Iciar M Dávila Castrodad; Erica S Simone; Jennifer Kurowicki; Justin X Melendez; Samuel J Mease; Vincent K McInerney; Anthony J Scillia Journal: Arthrosc Sports Med Rehabil Date: 2021-02-24