Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.
J Back Musculoskelet Rehabil. 2024;37(6):1729-1739. doi: 10.3233/BMR-240187.
Glenohumeral degenerative joint disease may affect up to 20% of the population. There are several classification systems of this disease in the scientific literature.
The aim of this study is to determine the reliability and reproducibility of glenohumeral osteoarthritis classification systems.
We assessed glenohumeral plain radiographs performed in a University Hospital. These radiographs were graded into nine radiological classification systems by two observers on two evaluations. Patients who have performed CT/MRI scan were staged according to the Walch classification. The intra-observer and inter-observer reliability of the classification schemes were determined by using Cohen's weighted kappa coefficient.
A total of 752 patients were included in the study (52.4% females and 47.6% males), mean aged 66.2 ± 16.3 years. The intra-observer and inter-observer reliabilities were 0.543 (observer 1), 0.630 (observer 2), and 0.760 (inter-observer) for the Weinstein grading system; 0.661, 0.706, and 0.761 for the Guyette grading system; 0.575, 0.679 and 0.704 for the Kellgren and Lawrence classification; 0.817, 0.816 e 0.871 for the Samilson and Prieto classification; 0.791, 0.811 and 0.847 for the Allain modification; 0.797, 0.842 and 0.860 for the Gerber modification; 0.773, 0.827 and 0.828 for the Buscayret modification; 0.584, 0.648 and 0.755 for the Hawkins and Angelo classification; 0.661, 0.749 and 0.764 for the Rosenberg classification. Intra-observer reliability for MRI was 0.757 (observer 1) and 0.675 (observer 2), while intra-observer reliability for CT was 0.811 (observer 1) and 0.653 (observer 2). Inter-observer reliabilities were 0.790 for MRI and 0.673 for CT.
The classification systems according to Weinstein, Guyette, Hawkins and Angelo, Rosenberg and the modifications of the Samilson and Prieto classification according to Allain, Gerber and Buscayret showed a comparable reliability with the commonly used glenohumeral osteoarthritis grading systems, Samilson and Prieto and Kellgren and Lawrence. Thus, they are recommended for clinical and especially scientific purposes.
盂肱关节退行性关节病可能影响多达 20%的人群。科学文献中有几种此类疾病的分类系统。
本研究旨在确定盂肱关节炎分类系统的可靠性和可重复性。
我们评估了在一所大学医院进行的盂肱关节平片。两名观察者在两次评估中，将这些平片分为九个放射学分类系统。对接受 CT/MRI 扫描的患者，根据 Walch 分类进行分期。使用 Cohen 的加权kappa 系数来确定分类方案的观察者内和观察者间可靠性。
本研究共纳入 752 例患者（52.4%女性和 47.6%男性），平均年龄为 66.2±16.3 岁。Weinstein 分级系统的观察者内和观察者间可靠性分别为 0.543（观察者 1）、0.630（观察者 2）和 0.760（观察者间）；Guyette 分级系统分别为 0.661、0.706 和 0.761；Kellgren 和 Lawrence 分类系统分别为 0.575、0.679 和 0.704；Samilson 和 Prieto 分类系统分别为 0.817、0.816 和 0.871；Allain 改良系统分别为 0.791、0.811 和 0.847；Gerber 改良系统分别为 0.797、0.842 和 0.860；Buscayret 改良系统分别为 0.773、0.827 和 0.828；Hawkins 和 Angelo 分类系统分别为 0.584、0.648 和 0.755；Rosenberg 分类系统分别为 0.661、0.749 和 0.764。MRI 的观察者内可靠性为 0.757（观察者 1）和 0.675（观察者 2），而 CT 的观察者内可靠性为 0.811（观察者 1）和 0.653（观察者 2）。观察者间可靠性为 MRI 0.790 和 CT 0.673。
根据 Weinstein、Guyette、Hawkins 和 Angelo、Rosenberg 以及根据 Allain、Gerber 和 Buscayret 对 Samilson 和 Prieto 分类的改良，与常用的盂肱关节炎分级系统 Samilson 和 Prieto 以及 Kellgren 和 Lawrence 相比，具有相当的可靠性。因此，推荐这些分类系统用于临床和特别是科学目的。
