Sports Medicine and Shoulder Surgery, Department of Orthopaedic Surgery, St Louis University, St Louis, MO, USA.
Knee Surg Sports Traumatol Arthrosc. 2011 Aug;19(8):1265-70. doi: 10.1007/s00167-010-1389-5. Epub 2011 Jan 22.
To validate the use of the clock face reference as a reliable means of communicating femoral intercondylar notch position.
A single red mark was made on ten identical left Sawbones femurs in the intercondylar notch at variable locations. Ten surgeons, who routinely perform ACL reconstructions, were presented the femurs in random order and asked to state the position of the mark to the nearest 30-min interval. Responses were recorded and then repeated 3 weeks later. The same 10 surgeons were presented with 30 actual arthroscopic photographs of the intercondylar notch, performed at 90° of knee flexion, with a probe pointing at various locations (10 knees; 3 photographs/knee) along the lateral aspect of the notch. The results were then analyzed with an ICC, Cronbach's alpha test, and descriptive statistics.
For the Sawbones, the ICC was 0.996 while individual physician's Cronbach's alpha test ranged from 0.954 to 0.999, indicating a very high interobserver and intraobserver reliability. The mean range of responses among the 10 surgeons was 1.6 h, SD 0.6. For the photographs, the ICC was also high at 0.997. There was a mean range of 1.1 h, SD 0.4, among surgeons.
The clock face method is commonly utilized for both placement of the femoral tunnel during ACL reconstruction as well as describing the location of the ACL femoral tunnel between communicating surgeons. Despite a high statistical interobserver correlation, there is significant range among different surgeons' responses. The present study questions the reliability of the clock face method for use between surgeons as a stand alone tool. Other methods also utilizing anatomic landmarks may be more accurate for describing intercondylar notch anatomy.
III.
验证钟面参考作为一种可靠的沟通股骨髁间窝位置的方法。
在十个相同的左 Sawbones 股骨髁间窝的不同位置上做一个单一的红色标记。十个常规进行 ACL 重建的外科医生以随机顺序展示股骨，并要求他们以最接近的 30 分钟间隔说出标记的位置。记录回答，然后在 3 周后重复。同样的 10 名外科医生展示了 30 张实际的关节镜照片，这些照片是在膝关节屈曲 90°时拍摄的，探针指向髁间窝外侧的不同位置（10 个膝关节；每个膝关节 3 张照片）。然后使用 ICC、Cronbach's alpha 测试和描述性统计对结果进行分析。
对于 Sawbones，ICC 为 0.996，而个别医生的 Cronbach's alpha 测试范围为 0.954 至 0.999，表明观察者间和观察者内的可靠性非常高。10 名外科医生的平均反应范围为 1.6 小时，标准差为 0.6。对于照片，ICC 也很高，为 0.997。外科医生的平均范围为 1.1 小时，标准差为 0.4。
钟面法常用于 ACL 重建时股骨隧道的放置以及描述沟通外科医生之间的 ACL 股骨隧道位置。尽管观察者间存在高度的统计学相关性，但不同外科医生的反应范围存在显著差异。本研究质疑钟面法作为独立工具在外科医生之间使用的可靠性。其他也利用解剖标志的方法可能更准确地描述髁间窝解剖结构。
III。
