Intraoperative arthroscopic classification tool for posterolateral elbow instability

Elisabeth A Wörner; Mustafa Kaynak; Roger van Riet; Bertram The; Denise Eygendaal

doi:10.1016/j.jseint.2023.02.016

Intraoperative arthroscopic classification tool for posterolateral elbow instability

JSES Int. 2023 Apr 13;7(6):2600-2604. doi: 10.1016/j.jseint.2023.02.016. eCollection 2023 Nov.

Authors

Elisabeth A Wörner^{1

2}, Mustafa Kaynak¹, Roger van Riet³, Bertram The², Denise Eygendaal^{1

2}

Affiliations

¹ Department of Orthopaedic Surgery, Erasmus MC, Rotterdam, The Netherlands.
² Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands.
³ Department of Orthopaedic Surgery, AZ Monica hospital, Deurne, Belgium.

Abstract

Background: Introducing and implementing an arthroscopic classification tool for posterolateral elbow instability.

Methods: Thirty arthroscopies were performed on 30 patients, and all recordings were collected, blinded, and labeled. Three orthopedic surgeons reviewed and scored all 30 recordings three times with a period of at least seven days in between to analyze the intraobserver and interobserver reliability. The classification consisted of five different grades.

Results: Indications for elbow arthroscopy included impingement (n = 7), osteochondritis dissecans (n = 5), pain (n = 7), osteoarthritis (n = 6), and other (n = 5). The kappa value for intrarater reliability was 0.71, indicating good reliability, while the kappa value for inter-rater reliability was 0.38 indicating fair reliability.

Conclusion: This new classification is a tool for an arthroscopic assessment of PLRI and can be used as a standardized grading system for further research and communication between orthopedic surgeons. We demonstrated good intrarater reliability (k = 0.71) with fair inter-rater reliability (k = 0.38). However, further research is necessary to study the clinical significance.

Keywords: Arthroscopy; Classification; Elbow; Instability; PLRI; Posterolateral elbow instability; Ulnohumeral joint.