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Archives of Orthopaedic and Trauma Surgery

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01-04-2014 | Arthroscopy and Sports Medicine

Low inter- and intraobserver variability allows for reliable tunnel measurement in ACL reconstruction using the quadrant method

Authors: Sven Shafizadeh, Maurice Balke, Stefan Kelz, Juergen Hoeher, Marc Banerjee

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 4/2014

Abstract

Introduction

Correct anatomic tunnel positions are essential in anterior cruciate ligament (ACL) reconstruction. To establish recommendations for tunnel positioning based on anatomical findings and to compare tunnel positions with clinical results, different radiological measurement methods as the quadrant method exist. Comparing the data of different observers requires the validation of the reliability of measurement methods. The purpose of this study therefore was to determine the reliability of the quadrant method to measure tunnel positions in ACL reconstruction. The hypothesis was, that the quadrant method shows a low inter- and intraobserver variability.

Materials and methods

In a test/retest scenario 20 knee surgeons were asked to determine defined tunnel positions in five lateral radiographs applying the quadrant method. Rotation, angle deviation, height and depth of the quadrant as well as absolute and relative tunnel positions of each observation were measured along referenced scales. Mean sizes and angle deviations of the quadrants, tunnel positions and deviations between the test/retest positions were calculated as well as standard deviations and range.

Results

Interobserver variability analyses, to plan as well as to determine tunnel positions in ACL reconstruction, showed a mean variability (SD) of <1 mm, with ranges of 2.5 mm for planning and 3.7 mm for determination of tunnel positions using the quadrant method. Intraobserver analysis showed mean variability with deviations of <1 mm and maximum standard deviations of 0.7 mm and ranges of up to 2.3 mm.

Conclusions

We confirmed the hypothesis that the quadrant method has a low inter- and intraobserver variability. Based on the presented validation data, the quadrant method can be recommended as reliable method to radiographically describe insertion areas of the ACL as well as to determine tunnel positions in ACL reconstruction intra and postoperatively.

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Title: Low inter- and intraobserver variability allows for reliable tunnel measurement in ACL reconstruction using the quadrant method
Authors: Sven Shafizadeh
Maurice Balke
Stefan Kelz
Juergen Hoeher
Marc Banerjee
Publication date: 01-04-2014
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 4/2014
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-014-1931-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Low inter- and intraobserver variability allows for reliable tunnel measurement in ACL reconstruction using the quadrant method

Abstract

Introduction

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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