Ren Shuang, Liu Zhenlong, Jiang Yanfang, Meng Qingyang, Zhu Jingxian, Shao Zhenxing, Hu Xiaoqing, Gong Xi, Ao Yingfang
Institute of Sports Medicine, Peking University Third Hospital, Beijing Key Laboratory of Sports Injuries Beijing, China.
Am J Transl Res. 2020 Dec 15;12(12):8059-8066. eCollection 2020.
Measurements of cartilage defect size under an arthroscope are essential for prognosis and treatment decisions. A new method called arthroscopic measurement by computer graphics (ACG) was developed to accurately calculate the size of the cartilage under an arthroscope. This study aimed to validate the accuracy and utility of this method. In this controlled laboratory study, the ACG method was validated by measuring the sizes of three cartilage defects in a knee joint of a pig, using the following techniques: traditional arthroscopic measurement by ruler (TAR), ACG, incised measurement by computer graphics (ICG), and incised measurement by ruler (IR, control, gold standard). Measurements were conducted by two blinded trained observers. Intra- and inter-observer variabilities were determined by calculating the intra-class correlation coefficient (ICC). Consistency among TAR, ACG, ICG and IR was analyzed using the command "Concord" in Stata. For arthroscopic measurements using ACG and ICG, the overall ICC intra- and inter-observer values were 0.99 and 0.98, respectively, which showed excellent reproductivity. The concord value showed consistency of various approaches relative to the gold standard method. The average concord value for TAR was 0.813, and the average concord value for ACG and ICG was 0.886 and 0.917, respectively. ACG utilizes computer graphics for measuring the size of cartilage defects of any size under an arthroscope, without reconditioning the injured cartilage. ACG showed excellent intra- and inter-observer reproducibility and satisfactory accuracy. This method would make it possible to more accurately match the graft with the defect, thereby facilitating cartilage repair.
关节镜下测量软骨缺损大小对于预后和治疗决策至关重要。一种名为计算机图形辅助关节镜测量（ACG）的新方法被开发出来，用于在关节镜下准确计算软骨大小。本研究旨在验证该方法的准确性和实用性。在这项对照实验室研究中，通过使用以下技术测量猪膝关节中的三个软骨缺损大小来验证ACG方法：传统的直尺关节镜测量（TAR）、ACG、计算机图形辅助切开测量（ICG）以及直尺切开测量（IR，对照，金标准）。测量由两名经过盲法训练的观察者进行。通过计算组内相关系数（ICC）来确定观察者内和观察者间的变异性。使用Stata中的“Concord”命令分析TAR、ACG、ICG和IR之间的一致性。对于使用ACG和ICG的关节镜测量，观察者内和观察者间的总体ICC值分别为0.99和0.98，显示出极好的重复性。一致性值显示了各种方法相对于金标准方法的一致性。TAR的平均一致性值为0.813，ACG和ICG的平均一致性值分别为0.886和0.917。ACG利用计算机图形学在关节镜下测量任何大小的软骨缺损，无需对损伤的软骨进行修整。ACG显示出极好的观察者内和观察者间重复性以及令人满意的准确性。该方法将使移植与缺损更精确匹配成为可能，从而促进软骨修复。
