title: Arthroscopic assessment of cartilage repair: a validation study of 2 scoring systems.
abstract: OBJECTIVE
  This study tested the validity and reliability of the International Cartilage Repair Society (ICRS) cartilage repair assessment and the Oswestry Arthroscopy Score (OAS), which have been designed to assess repair of articular cartilage.
  
  
  METHODS
  Prospective validation study of arthroscopic cartilage repair scores.
  
  
  METHODS
  Arthroscopic videos were assessed by a panel of orthopaedic surgeons specializing in cartilage repair. Scoring was repeated after a 2-month interval. Scorers also answered a questionnaire to assess the face and content validity of the scoring systems. Validity of the 2 systems was compared and reliability and repeatability were measured. Pearson's correlation coefficient was used to measure equivalence reliability. The interclass correlation coefficient (ICC) was used to assess the repeatability and inter-rater reliability of each score, and internal consistency was assessed with Cronbach's alpha.
  
  
  RESULTS
  Face and content validity are acceptable for both scores. There is good agreement (equivalence reliability) between the scores (Pearson's correlation coefficient, r = .88; P < .001). Stability (interobserver reliability) and repeatability (test-retest reliability) are satisfactory for both scores with an ICC >0.7 for each score. Cronbach's alpha was 0.91 for ICRS and 0.82 for OAS, indicating better internal consistency for the ICRS score.
  
  
  CONCLUSIONS
  The ICRS and OAS arthroscopic scores have been validated for the assessment of cartilage repair and both have been found to be statistically reliable and repeatable. The ICRS score does not allow for graft hypertrophy and may overscore in this situation, whereas the OAS includes assessment of graft stiffness. Both scores show satisfactory stability and repeatability. Internal consistency is adequate for both scores, although it is higher for the ICRS score. Both the ICRS and OAS arthroscopic scores are effective tools in the evaluation of cartilage repair.
  
  
  METHODS
  Level III, diagnostic study of nonconsecutive patients (no consistently applied reference gold standard).
authors.affiliation: Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, England. gdsmith@doctors.org.uk
authors.forename: Graham D
authors.initials: GD
authors.lastname: Smith
authors.forename: Jo
authors.initials: J
authors.lastname: Taylor
authors.forename: Karl Fredrik
authors.initials: KF
authors.lastname: Almqvist
authors.forename: Christoph
authors.initials: C
authors.lastname: Erggelet
authors.forename: Gunnar
authors.initials: G
authors.lastname: Knutsen
authors.forename: Montse
authors.initials: M
authors.lastname: Garcia Portabella
authors.forename: Tony
authors.initials: T
authors.lastname: Smith
authors.forename: James B
authors.initials: JB
authors.lastname: Richardson
mesh_terms: D001182:Arthroscopy; D019902:Chondrocytes / Q000637:transplantation; D005500:Follow-Up Studies; D006801:Humans; D008592:Menisci, Tibial / Q000601:surgery*; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014182:Transplantation, Autologous; D014743:Videotape Recording