The effect of additional video documentation to photo documentation in wrist arthroscopies on intra- and interobserver reliability

Löw, Steffen; Pillukat, Thomas; Prommersberger, Karl-Josef; Schoonhoven, Jörg van

doi:10.1007/s00402-012-1670-9

Cited by 20 publications

(11 citation statements)

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“…Whereas the classification of Geissler et al 31 is widely accepted, some surgeons doubt that the insertion of the probe in between the two bones from midcarpal constitutes a relevant SL ligament lesion. 4 Repeat arthroscopic irrigation and debridement for aseptic or septic arthritis finally accounted for seven patients. With respect to septic arthritis, institution 1 repeated arthroscopies for persistent clinical signs of infection, whereas institution 2 performed repeat arthroscopy the next day according to the house treatment regimen for septic arthritis.…”

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confidence: 99%

“…2 On the other hand, insufficient photo or video documentation impedes others from reproducing what was diagnosed during arthroscopy. [3][4][5][6] Therefore, for those who perform definitive treatment, repeat arthroscopy serves to get an own idea of the wrists' status. Studies reporting on the incidence and causes for revision arthroscopies in larger joints are numerous.…”

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confidence: 99%

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Preventable Repeat Wrist Arthroscopies: Analysis of the Indications for 133 Cases

et al. 2016

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Frequently, patients undergo repeated wrist arthroscopies for single wrist problems. The purposes of this study were to assess the indications for repeat wrist arthroscopies and to identify potentially preventable procedures. For this retrospective, two-center study, the electronic patient records were examined for patients, who underwent repeat wrist arthroscopy in a 5-year period. The cases were sorted by the underlying pathologies and the causes that necessitated repeat arthroscopies. Ulnar-sided wrist pain accounted for 100 (77%) of all 133 revision arthroscopies: 67 of which due to suspected ulnar triangular fibrocartilage complex (TFCC) avulsions, 33 due to ulnar impaction syndromes. Cartilage was reassessed in 22 (17%) wrists. Thereby, insufficient preoperative diagnostics necessitated pure diagnostic before therapeutic arthroscopy in 49 (37%) wrists: 48 of which for TFCC pathologies, one for a scapholunate (SL) ligament lesion. The uncertainty of diagnosis despite previous arthroscopy necessitated 18 (14%) revision arthroscopies: 15 for ulnar TFCC avulsions, 1 for a central TFCC lesion, 2 to reevaluate the SL ligament. Inadequate photo or video documentation of the cartilage necessitated arthroscopic reassessment in 16 (12%) wrists. In this series, two out of three revision arthroscopies could potentially have been prevented. Inadequate preoperative diagnostics with the lack of reliable preoperative diagnoses necessitated pure diagnostic arthroscopies for ulnar-sided wrist pain. However, even arthroscopically, the diagnosis of ulnar TFCC avulsions or SL ligament lesions is not trivial. Surgical skills and experience are necessary to detect such lesions. Finally, adequate photo or video documentation may prevent repeated arthroscopic diagnostic procedures. Level IV.

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Preventable Repeat Wrist Arthroscopies: Analysis of the Indications for 133 Cases

et al. 2016

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“…Um die Lokalisation der TFCC-Verletzung und deren Ausmaß präzise zu identifizieren, gilt die Handgelenkarthroskopie trotz aller Fortschritte der bildgebenden Verfahren immer noch als Referenzstandard (s. auch Zusatzmaterial online: Videos 1 und 3, [42]). Bei der Arthroskopie von radiokarpal ist es allerdings nur möglich, Läsionen des oberflächlichen TFCC-Blatts und Komplettabrisse direkt zu visualisieren.…”

Section: Handgelenkarthroskopieunclassified

Instability of the distal radioulnar joint

Spies¹,

Prommersberger

Langer

et al. 2015

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Injuries of the triangular fibrocartilage complex (TFCC) may be fatal to the distal radioulnar joint (DRUJ). This structure is one of the crucial stabilizers and guarantees unrestricted pronosupination of the forearm. A systematic examination is mandatory to diagnose DRUJ instability reliably. A clinical examination in comparison to the contralateral side is obligatory. Plain radiographs are required to exclude osseous lesions or deformities. Computed tomography of both wrists in neutral, pronation and supination is necessary to verify DRUJ instability in ambiguous situations. Based on a systematic examination wrist and DRUJ arthroscopy identify lesions clearly. Injuries of the radioulnar ligaments which entail DRUJ instability, should be reconstructed preferably anatomically. Ulnar-sided TFCC lesions may often cause DRUJ instability. Osseous ligament avulsions are mostly treated osteosynthetically. Ligament tears may be refixated using anchor or transosseous sutures. Tendon transplants are necessary for an anatomical reconstruction in cases of irreparable ruptures.

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“…Moreover, independent raters do not necessarily classify this finding as partial or even complete SL tear. [4][5][6] Instead, they judge this finding as normal without any pathological value for many patients.…”

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Significance of Scapholunate Gap Width as Measured by Probe from Midcarpal

et al. 2017

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Geissler's classification is widely accepted in arthroscopic diagnostics of scapholunate (SL) ligament injury. Thereby, probe insertion into the SL gap from the midcarpal would indicate treatment necessity in patients with SL tear as seen from radiocarpal view. In this review, the SL gap width, examined by the probe from midcarpal, was arthroscopically assessed in patients with intact SL ligaments, who were treated for ulnar impaction syndrome. The review examined how often lax SL joints can be found in patients with no complaints with respect to the SL ligaments and in which the SL ligaments were proven to be intact from radiocarpal view. We suspected that probe insertion, as an indicator for a lax joint, does not affect the outcome in ulnar impaction treatment. A total of 32 patients with clinically diagnosed ulnar impaction syndrome were arthroscopically treated by central resection and debridement of the triangular fibrocartilage; 8 patients underwent concurrent ulnar shortening, and 4 of them finally hardware removal. All patients were examined preoperatively as well as after 3, 6, and 12 months following arthroscopy, respectively, after ulnar shortening or hardware removal. In 14 patients, the probe could not, in 18 patients, the probe could be inserted into the SL gap. There was neither any significant difference in the improvement of pain, grip strength, Krimmer, or DASH score, nor for any of the radiographic angles between the two groups. Laxity of the SL ligament allows the probe to be inserted into the SL gap from midcarpal in some patients. This finding, therefore, does not necessarily imply the necessity of treatment when there is partial rupture seen from radiocarpal view. Level III, case-control study.

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The effect of additional video documentation to photo documentation in wrist arthroscopies on intra- and interobserver reliability

Abstract: As long as videos do not meet further quality criteria, they are not able to improve reliability in general. Nevertheless, videos should be used for documentation of the TFCC.

Cited by 20 publications

References 14 publications

Preventable Repeat Wrist Arthroscopies: Analysis of the Indications for 133 Cases

Preventable Repeat Wrist Arthroscopies: Analysis of the Indications for 133 Cases

Instability of the distal radioulnar joint

Significance of Scapholunate Gap Width as Measured by Probe from Midcarpal

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