Osteochondritis dissecans of the humeral capitellum: reliability of four classification systems using radiographs and computed tomography

Claessen, Femke M.A.P.; Ende, Kimberly I.M. van den; Doornberg, Job N.; Guitton, Thierry G.; Eygendaal, Denise; Bekerom, Michel P.J. van den; Lugt, J. van der; Schep, Niels W. L.; Boerboom, A.L.; Pluim, M. van der; Wagener, Marc L.; Beumer, Annechien; Kloen, Peter; Keijser, C.M.; Deurzen, Derek F.P. van; Mansat, Pierre; Somford, Matthijs P.; Jaspars, C.C.J.; Kolovich, Gregory P.; Cheung, Jacky; Tongel, Alexander Van; Blokzijl, Reinoud J.; Heijnk, A.; Alta, T.D.W.; Heerspink, O. Lambers; Dijk, Pim van; Noort, Arthur van; Lisowski, Lukas A.; Ekholm, Carl; Shafritz, Adam B.; Garrigues, Grant E.; Porcellini, Giuseppe; Mazzocca, Augustus D.; Kaar, Scott G.; Duncan, Scott F. M.; Patel, Minoo; Patiño, Juan Martín; Paladini, Paolo

doi:10.1016/j.jse.2015.03.029

Cited by 33 publications

(24 citation statements)

References 45 publications

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“…years in practice, number of OCD cases per year, specialty) were analyzed. 22,27,29 Statistical analysis was performed with the use of Stata 12.0 (StataCorp LP, College Station, TX, USA).…”

Section: Discussionmentioning

confidence: 99%

“…Point estimates and two-sided 95% confidence intervals (CIs) were calculated as well. 22 , 27 – 29 The multirater kappa is a commonly used statistic to describe chance-corrected agreement in interobserver studies. A value of 0 indicates no agreement beyond chance alone.…”

Section: Methodsmentioning

confidence: 99%

“… 7 , 9 , 18 – 21 Both CT and MR have shown to correlate well with intraoperative findings 7 , 9 ; however, classifying the stage of an OCD on CT images has been shown to be interpreted inconsistently among surgeons specialized in upper extremity injuries. 22 Because surgical decision making and preoperative planning highly depend on lesion stability, size and location of the lesion, it is important to know if physicians interpret MR images regarding these characteristics in a consistent manner.…”

Section: Introductionmentioning

confidence: 99%

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Interobserver reliability of the classification of capitellar osteochondritis dissecans using magnetic resonance imaging

et al. 2019

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Aim (1) To determine the interobserver reliability of magnetic resonance classifications and lesion instability criteria for capitellar osteochondritis dissecans lesions and (2) to assess differences in reliability between subgroups. Methods Magnetic resonance images of 20 patients with capitellar osteochondritis dissecans were reviewed by 33 observers, 18 orthopaedic surgeons and 15 musculoskeletal radiologists. Observers were asked to classify the osteochondritis dissecans according to classifications developed by Hepple, Dipaola/Nelson, Itsubo, as well as to apply the lesion instability criteria of DeSmet/Kijowski and Satake. Interobserver agreement was calculated using the multirater kappa (k) coefficient. Results Interobserver agreement ranged from slight to fair: Hepple (k = 0.23); Dipaola/Nelson (k = 0.19); Itsubo (k = 0.18); DeSmet/Kijowksi (k = 0.16); Satake (k = 0.12). When classifications/instability criteria were dichotomized into either a stable or unstable osteochondritis dissecans, there was more agreement for Hepple (k = 0.52; p = .002), Dipaola/Nelson (k = 0.38; p = .015), DeSmet/Kijowski (k = 0.42; p = .001) and Satake (k = 0.41; p < .001). Overall, agreement was not associated with the number of years in practice or the number of osteochondritis dissecans cases encountered per year (p > .05). Conclusion One should be cautious when assigning grades using magnetic resonance classifications for capitellar osteochondritis dissecans. When making treatment decisions, one should rather use relatively simple distinctions (e.g. stable versus unstable osteochondritis dissecans; lateral wall intact versus not intact), as these are more reliable.

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“…years in practice, number of OCD cases per year, specialty) were analyzed. 22,27,29 Statistical analysis was performed with the use of Stata 12.0 (StataCorp LP, College Station, TX, USA).…”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Interobserver reliability of the classification of capitellar osteochondritis dissecans using magnetic resonance imaging

et al. 2019

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“…X-rays, CT, and MRI all have a role in identifying lesions and in determining lesion stability, an important consideration for determining nonoperative or operative treatment. Radiographic features of a stable lesion include flattening and radiolucency [18,21,22]. Any signs of sclerosis or fragmentation are features of unstable lesions.…”

Section: Imagingmentioning

confidence: 99%

Osteochondritis dissecans lesions of the capitellum in overhead athletes: a review of current evidence and proposed treatment algorithm

Logli

Bernard

O’Driscoll

et al. 2019

Curr Rev Musculoskelet Med

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Purpose of the Review To review the most recent literature on osteochondritis dissecans (OCD) lesions of the capitellum in overhead athletes and describe a treatment algorithm based on current best evidence and surgeon experience. Recent Findings Recent research has included larger cohort studies with longer follow-up as well as quality systematic reviews and meta-analyses. These studies have focused on understanding how lesion characteristics such as size, location, and appearance on advanced imaging can predict treatment success. Current literature continues to support nonoperative management for stable lesions. Operative intervention is generally required for unstable lesions and treatment strategies are largely dictated by lesion size and location: debridement or reparative techniques for small lesions while larger lesions or those in high-stress locations are better served by bone and/or cartilage restoration procedures. There has been a rising interest in the use of allograft materials and cellbased therapies. Summary Overhead athletes are uniquely predisposed to capitellar OCD due to the nature of forces applied to the radiocapitellar joint during repeated activity in the overhead position. Despite improvements in operative techniques, successful use of alternative graft materials, and a better understanding of how lesion characteristics influence results, there is still much to learn about this challenging disorder. Future research should focus on comparing operative techniques, refining their indications, and further developing a reliable treatment algorithm that best serves the overhead athlete. Keywords Osteochondritis dissecans (OCD). Humeral capitellum. Overhead athlete. Elbow pain. Baseball players. Gymnasts This article is part of the Topical Collection on Injuries in Overhead Athletes

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“…Several classifications have been described for OCD of the elbow; the value of grading of capitellar OCD seems limited 35. Most classifications are based on standard radiographs, as the Minami Classification, CT, MRI, or arthroscopy 23…”

Section: Current State-of-the-artmentioning

confidence: 99%

Osteochondritis dissecans of the elbow: state of the art

Eygendaal

Bain

Pederzini³

et al. 2017

Journal of ISAKOS

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Osteochondritis dissecans of the humeral capitellum: reliability of four classification systems using radiographs and computed tomography

Cited by 33 publications

References 45 publications

Interobserver reliability of the classification of capitellar osteochondritis dissecans using magnetic resonance imaging

Interobserver reliability of the classification of capitellar osteochondritis dissecans using magnetic resonance imaging

Osteochondritis dissecans lesions of the capitellum in overhead athletes: a review of current evidence and proposed treatment algorithm

Osteochondritis dissecans of the elbow: state of the art

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