Kessler S, Guenther K P, Puhl W
Orthopaedic Department (RKU), University of Ulm, Germany.
Clin Rheumatol. 1998;17(3):205-9. doi: 10.1007/BF01451048.
In clinical and epidemiological studies the Kellgren & Lawrence (K&L) scale was mainly used in the past to determine the radiological prevalence and severity of gonarthritis. The dependency of this scoring system on the presence of osteophytes has been criticised, and owing to its varying reliability, its appropriateness in cross-sectional and longitudinal studies is questioned. It was the purpose of this study to test whether the dependency of the K&L scale on the presence of osteophytes is reflected in a higher correlation of the overall score with a separate scoring of 'osteophytes' than with other radiological features. Furthermore we compared the inter- and intrarater reliability with the reliability of individual radiological features. Knee radiographs of 40 patients were graded according to the K&L scale and for the presence and severity of five separate radiological features of osteoarthritis. We found a moderate correlation of the K&L scale with the radiological features of 'osteophytes', 'joint space narrowing' and 'flattening of condyles'. The intra- and inter-rater reliability of the K&L scale was higher than the reliability of the individual radiological features. The K&L scale seems not to be strongly dependent on the presence of osteophytes, i.e. there is not a higher correlation of the overall score with that feature than with other radiological features.
在临床和流行病学研究中，过去主要使用凯尔格伦和劳伦斯（K&L）量表来确定膝关节炎的放射学患病率和严重程度。该评分系统对骨赘存在的依赖性受到了批评，并且由于其可靠性存在差异，其在横断面和纵向研究中的适用性也受到质疑。本研究的目的是检验K&L量表对骨赘存在的依赖性是否表现为总分与“骨赘”单独评分的相关性高于与其他放射学特征的相关性。此外，我们还将评分者间和评分者内的可靠性与各个放射学特征的可靠性进行了比较。根据K&L量表以及骨关节炎五个独立放射学特征的存在情况和严重程度，对40例患者的膝关节X线片进行了分级。我们发现K&L量表与“骨赘”“关节间隙变窄”和“髁部扁平”的放射学特征之间存在中度相关性。K&L量表的评分者内和评分者间可靠性高于各个放射学特征的可靠性。K&L量表似乎并不强烈依赖于骨赘的存在，即总分与该特征的相关性并不高于与其他放射学特征的相关性。
