Faculté de Médecine de Tours, Université de Tours, CHRU Trousseau Service d'Orthopédie Traumatologie, 1C avenue de la République, 37170 Chambray-les-Tours, France.
Institut Ostéo Articulaire Paris Courcelles, Paris, France.
Orthop Traumatol Surg Res. 2023 Apr;109(2):103509. doi: 10.1016/j.otsr.2022.103509. Epub 2022 Dec 7.
Long head of the biceps (LHB) pathology is frequent but can be difficult to diagnose. Arthroscopy is the current diagnostic gold-standard. The aim of the present study was to assess inter- and intra-observer agreement in arthroscopic analysis of the LHB.
Agreement in arthroscopic analysis of the LHB is good in the particular case of small rotator cuff tears.
This prospective study included 49 patients operated on between November 1 and November 30, 2017. Seven surgeons were asked to record videos of arthroscopic LHB analysis for Patte-1 small supraspinatus tendon tears. One junior and 2 senior surgeons analyzed the videos independently, studying macroscopic intrinsic and extrinsic LHB aspect. Inter-observer agreement, and intra-observer agreement for the junior surgeon, were analyzed.
Inter-observer agreement between the surgeons and intra-observer agreement for the junior surgeon were slight in describing the pathologic aspect of the LHB: respectively, κ=0.254, p<0.038; and κ=0.319, p<0.0019.
Isolated arthroscopic LHB assessment without clinical or paraclinical input or precise surgical exploration protocol showed slight inter-observer agreement. Analysis and interpretation of LHB aspect should in practice be based on combined clinical, paraclinical and arthroscopic data.
III.
长头肱二头肌(LHB)病变较为常见,但诊断较为困难。关节镜检查是目前的诊断金标准。本研究旨在评估关节镜分析 LHB 时的观察者间和观察者内的一致性。
在小肩袖撕裂的特殊情况下,关节镜分析 LHB 的一致性良好。
这是一项前瞻性研究,纳入了 2017 年 11 月 1 日至 30 日期间接受手术的 49 名患者。7 名外科医生被要求记录关节镜下 LHB 分析的视频,用于 Patte-1 型小冈上肌腱撕裂。1 名初级外科医生和 2 名高级外科医生独立分析了视频,研究了 LHB 的宏观内在和外在方面。分析了观察者间和初级外科医生的观察者内一致性。
外科医生之间的观察者间一致性和初级外科医生的观察者内一致性在描述 LHB 的病理方面均为轻微:分别为κ=0.254,p<0.038;和κ=0.319,p<0.0019。
在没有临床或辅助检查输入或精确手术探查方案的情况下,单独进行关节镜 LHB 评估显示出轻微的观察者间一致性。在实践中,LHB 方面的分析和解释应基于临床、辅助检查和关节镜数据的综合。
III 级。