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This Article Full Text Full Text (PDF) All Versions of this Article: 32/8/1937    most recent 0363546504264586v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Dunn, W. R. Articles by Spindler, K. P. Search for Related Content PubMed PubMed Citation Articles by Dunn, W. R. Articles by Spindler, K. P. Related Collections Knee Meniscus Arthroscopy

Multirater Agreement of Arthroscopic Meniscal Lesions

Warren R. Dunn, MD, MPH^*,, Brian R. Wolf, MD, Annunziato Amendola, MD, Jack T. Andrish, MD, Christopher Kaeding, MD^||, Robert G. Marx, MD, MSc, FRCSC, Eric C. McCarty, MD^¶, Richard D. Parker, MD, Rick W. Wright, MD^# and Kurt P. Spindler, MD^**

From the Hospital for Special Surgery, New York, New York, the University of Iowa Hospitals and Clinics, Iowa City, Iowa, the Cleveland Clinic Foundation, Cleveland, Ohio, the ^|| Ohio State Sports Medicine Center, Columbus, Ohio, the ^¶ Colorado University Sports Medicine, Denver, Colorado, the ^# Washington University Orthopedic & Sports Medicine Center, St. Louis, Missouri, and the ^** Vanderbilt Sports Medicine Center, Nashville, Tennessee

^* Address correspondence to Warren R. Dunn, MD, MPH, Vanderbilt Sports Medicine, 2601 Jess Neely Drive, Nashville, TN 37212 (e-mail: dunnw{at}hss.edu).

Background: Establishing the validity of classification schemes is a crucial preparatory step that should precede multicenter studies. There are no studies investigating the reproducibility of arthroscopic classification of meniscal pathology among multiple surgeons at different institutions.

Hypothesis: Arthroscopic classification of meniscal pathology is reliable and reproducible and suitable for multicenter studies that involve multiple surgeons.

Study Design: Multirater agreement study.

Methods: Seven surgeons reviewed a video of 18 meniscal tears and completed a meniscal classification questionnaire. Multirater agreement was calculated based on the proportion of agreement, the kappa coefficient, and the intraclass correlation coefficient.

Results: There was a 46% agreement on the central/peripheral location of tears ( = 0.30), an 80% agreement on the depth of tears ( = 0.46), a 72% agreement on the presence of a degenerative component ( = 0.44), a 71% agreement on whether lateral tears were central to the popliteal hiatus ( = 0.42), a 73% agreement on the type of tear ( = 0.63), an 87% agreement on the location of the tear ( = 0.61), and an 84% agreement on the treatment of tears ( = 0.66). There was considerable agreement among surgeons on length, with an intraclass correlation coefficient of 0.78, 95% confidence interval of 0.57 to 0.92, and P < .001.

Conclusions: Arthroscopic grading of meniscal pathology is reliable and reproducible.

Clinical Relevance: Surgeons can reliably classify meniscal pathology and agree on treatment, which is important for multicenter trials.

Key Words: multicenter • meniscus • multirater agreement • Multicenter Orthpaedic Outcomes Network (MOON)