Evaluation of the inter and intraobserver reproducibility of the "defect coverage index method", a new computed tomography assessment method of sagittal graft positioning in arthroscopic bone block procedures

Cristina Delgado; Ignacio De Rus; Pablo Cañete; Jorge Díaz; Raquel Ruiz; Miguel García Navlet; Miguel Ángel Ruiz Ibán

doi:10.1186/s40634-023-00590-3

Evaluation of the inter and intraobserver reproducibility of the "defect coverage index method", a new computed tomography assessment method of sagittal graft positioning in arthroscopic bone block procedures

J Exp Orthop. 2023 Mar 30;10(1):35. doi: 10.1186/s40634-023-00590-3.

Authors

Cristina Delgado¹, Ignacio De Rus², Pablo Cañete³, Jorge Díaz⁴, Raquel Ruiz⁴, Miguel García Navlet⁵, Miguel Ángel Ruiz Ibán⁶

Affiliations

¹ Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
² Hospital Universitario Torrejón, Madrid, Spain.
³ Hospital Manises, Valencia, Spain.
⁴ Shoulder and Elbow Reconstructive Surgery Unit. Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain.
⁵ Hospital Asepeyo Coslada, Madrid, Spain.
⁶ Shoulder and Elbow Reconstructive Surgery Unit. Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain. drmri@hotmail.com.

Abstract

Purpose: To assess the reproducibility of a new 2-dimensional computed tomography (CT) method of assessing graft positioning in arthroscopic bone block procedure.

Methods: This is a prospective observational study. Twenty-seven patients, (all men, mean [Standard deviation] age at surgery 30.9 [8.49] years) were included. Vertical graft position was assessed on the sagittal view by measuring the amount of glenoid bone defect covered by the graft. The length of the bone defect and the amount of graft covering the defect were measured. Positioning of the graft on the sagittal plane was classified as accurate if the graft covered at least 90% of the defect. Intraobserver and interobserver reproducibility was analyzed using intraclass correlation coefficients (ICC) and Kappa coefficient with 95% confidence.

Results: Excellent intraobserver reproducibility was found, with an ICC of 0.94 (CI 95%, 0.86-0.97). Interobserver reproducibility was good, with the ICC value of 0.71, ranging from 0.45 to 0.86 (CI 95%).

Conclusion: This new method of assessing graft positioning in arthroscopic bone block procedures on 2-dimensional computed tomography scans is reliable, with an excellent intraobserver and good interobserver reproducibility.

Level of evidence: III.

Keywords: Bone block procedure; Computed tomography; Glenoid bone defect; Reproducibility; Sagittal position; Shoulder instability.