Günther K P, Scharf H P, Puhl W, Willauschus W, Kalke Y, Glückert K, Sun Y
Orthopädische Abteilung des RKU, Orthopädische Klinik mit Querschnittgelähmtenzentrum der Universität Ulm.
Z Orthop Ihre Grenzgeb. 1997 May-Jun;135(3):197-202. doi: 10.1055/s-2008-1039580.
Ongoing efforts of the "German Society of Orthopaedic Surgery and Traumatology" (DGOT) to standardize diagnosis and therapy of osteoarthritis, necessitated this study, where the reproducibility of different radiographic features of knee-OA was assessed.
Three readers graded 100 antero-posterior and lateral knee radiographs for selected features (femorotibial osteophytes, joint space narrowing, sclerosis and chondrocalcinosis; patellofemoral osteophytes) and an overall-score (Kellgren and Lawrence, 1963) at two time points 3 months apart. Intra- and inter-observer-reliability were calculated by intra-class correlation-coefficient (ICC).
Osteophytes in the femorotibial as well as in the patellofemoral joint could be assessed with a high intra- and inter-observer-reliability. While for joint space narrowing intra-observer-reliability is excellent, the inter-observer-reliability is less satisfactory, and subchondral sclerosis as well as chondrocalcinosis showed even less reproducibility. The Kellgren-Lawrence global score proofed to be highly reproducible.
Based on the results of this examination, we can recommend a reliable radiographic classification of knee osteoarthritis by grading of relevant individual features (osteophytes and joint space narrowing) and overall assessment.
“德国骨外科学与创伤学协会”（DGOT）持续致力于骨关节炎诊断和治疗的标准化，因此开展了本研究，旨在评估膝关节骨关节炎不同影像学特征的可重复性。
三位阅片者对100张膝关节前后位和侧位X线片的选定特征（胫股骨赘、关节间隙变窄、硬化和软骨钙质沉着；髌股骨赘）以及一个总体评分（Kellgren和Lawrence，1963年）在相隔3个月的两个时间点进行分级。观察者内和观察者间的可靠性通过组内相关系数（ICC）计算。
胫股关节和髌股关节的骨赘在观察者内和观察者间的可靠性都很高。虽然关节间隙变窄的观察者内可靠性极佳，但观察者间可靠性不太令人满意，而软骨下硬化和软骨钙质沉着的可重复性更低。Kellgren-Lawrence总体评分被证明具有高度可重复性。
基于本次检查结果，我们建议通过对相关个体特征（骨赘和关节间隙变窄）进行分级以及总体评估，对膝关节骨关节炎进行可靠的影像学分类。
