The reliability between surgeons comparing arthroscopic and video evaluation of patients with shoulder impingement syndrome.
OBJECTIVE
To assess interobserver reliability between 2 surgeons, for real-time diagnostic arthroscopy and the corresponding videotape of shoulder pathology in patients with a clinical symptom complex consistent with shoulder impingement syndrome.


METHODS
Prospective cohort.


METHODS
Fifty-three patients with shoulder impingement syndrome underwent arthroscopic surgery by 1 of 2 experienced orthopaedic shoulder surgeons. All operations were videotaped. The surgeon who did not perform the surgery reviewed the videotaped procedure. The findings in the shoulder were independently documented by each surgeon on standardized shoulder information sheets. The video-review surgeon was blinded to the results of the arthroscopy and all preoperative workup information. The percentage agreement, kappa statistics, and correlations were calculated to assess the inter-rater reliability.


RESULTS
The percentage agreement ranged from 100% for tendon ruptures to 39% when identifying acromion type. Interobserver kappa statistics were significant for all relevant structures with the exception of acromion type and coracoacromial ligament.


CONCLUSIONS
There was satisfactory reliability between video and real-time arthroscopy. However, better objective definitions of pathology and standardization of arthroscopic techniques would improve these results. Videotaping of arthroscopy can be considered a useful educational tool, a way to improve communication between surgeons, and possibly a medicolegal tool when defining pathology in the shoulder.


METHODS
Level II.
Mohtadi
Nicholas G H
NG
Sport Medicine Centre, University of Calgary, Calgary, Alberta, Canada. mohtadi@ucalgary.ca <mohtadi@ucalgary.ca>
Jager
Frances L
FL
Sasyniuk
Treny M
TM
Hollinshead
Robert M
RM
Fick
Gordon H
GH
D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000706:statistics & numerical data; D005260:Female; D013502:General Surgery / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D019534:Shoulder Impingement Syndrome / Q000175:diagnosis*; D014741:Video Recording / Q000706:statistics & numerical data