Multirater agreement of arthroscopic meniscal lesions.
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.


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


METHODS
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 (kappa = 0.30), an 80% agreement on the depth of tears (kappa = 0.46), a 72% agreement on the presence of a degenerative component (kappa = 0.44), a 71% agreement on whether lateral tears were central to the popliteal hiatus (kappa = 0.42), a 73% agreement on the type of tear (kappa = 0.63), an 87% agreement on the location of the tear (kappa = 0.61), and an 84% agreement on the treatment of tears (kappa = 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.


CONCLUSIONS
Surgeons can reliably classify meniscal pathology and agree on treatment, which is important for multicenter trials.
Dunn
Warren R
WR
Hospital for Special Surgery, New York, New York, USA. dunnw@hss.edu
Wolf
Brian R
BR
Amendola
Annunziato
A
Andrish
Jack T
JT
Kaeding
Christopher
C
Marx
Robert G
RG
McCarty
Eric C
EC
Parker
Richard D
RD
Wright
Rick W
RW
Spindler
Kurt P
KP
D001182:Arthroscopy / Q000592:standards*; D006801:Humans; D007718:Knee Injuries / Q000145:classification*; D008592:Menisci, Tibial / Q000473:pathology; D015588:Observer Variation; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D000070600:Tibial Meniscus Injuries; D014741:Video Recording