Inter-observer and intra-observer reliability of mechanical axis alignment before and after total knee arthroplasty using long leg radiographs

The Knee
Anneka BowmanJeganath Krishnan

Abstract

Long leg radiographs (LLRs) are commonly performed for assessment of mechanical alignment and operative planning in patients undergoing total knee arthroplasty (TKA). The aim of this study was to determine the inter- and intra-observer reliability of alignment measured by observers of different levels of experience. Forty patients on the waiting list for a TKA had pre- and post-operative standardised LLRs. We analysed the measurements of mechanical axis alignment between an orthopaedic surgeon, a senior orthopaedic registrar, a junior orthopaedic registrar, and a medical student. Reviewers performed blinded measurements on the same computer screen. These measurements were repeated three months later to assess intra-observer reliability. Furthermore high-resolution screens were compared with standard hospital computer screens to investigate whether monitoring quality influenced the accuracy of measurements of alignment. Inter-observer reliability was high for pre-operative LLRs with an intra-class correlation (ICC) of >0.9 at all experience levels. Post-operative ICC was lowest between the surgeon and the medical student at 0.7. Intra-observer reliability was high at all experience levels. Larger deformities appeared to have exa...Continue Reading

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Citations

Jan 23, 2017·Archives of Orthopaedic and Trauma Surgery·E ThienpontJ Victor
Nov 11, 2019·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Lukas JudLazaros Vlachopoulos
Sep 9, 2020·The Journal of Knee Surgery·Vicente Jesús León-MuñozFernando Santonja-Medina
Jul 12, 2018·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Robert Karl ZahnHagen Hommel
Jul 20, 2017·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Daphne A L SchoenmakersPieter J Emans
Jul 23, 2020·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Lucas BeckersPieter-Jan Vandekerckhove
Feb 16, 2021·Orthopaedics & Traumatology, Surgery & Research : OTSR·Jean-Claude Bové, Arnaud Clavé
May 4, 2021·Radiology. Artificial Intelligence·Gustav Andreisek
Oct 15, 2021·Orthopaedics & Traumatology, Surgery & Research : OTSR·Florian BarbotteNicolas Pujol

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