| چکیده انگلیسی مقاله |
Background: It is not always clear how to treat glenohumeral osteoarthritis, particularly in young patients. The goals ofthis study were to 1) quantify how patient age, activity level, symptoms, and radiographic findings impact the decisionmakingof shoulder specialists and 2) evaluate the observer reliability of the Kellgren-Lawrence (KL) grading system forprimary osteoarthritis of the shoulder.Methods: Twenty-six shoulder surgeons were each sent 54 simulated patient cases. Each patient had a differentcombination of age, symptoms, activity level, and radiographs. Responders graded the radiographs and chose atreatment (non-operative, arthroscopy, hemiarthroplasty, or total shoulder arthroplasty). Spearman correlations andchi square tests were used to assess the relationship between factors and treatments. Sub-analysis was performedon surgical cases. An intra-class correlation (ICC) was used to assess observer agreement.Results: The significant correlations (P< 0.01) were: symptoms [0.46], KL grade [0.44], and age [0.11]. In the subanalysisof operative cases, the significant correlations were: KL grade [0.64], age [0.39], and activity level [-0.10].The chi square analysis was significant (P< 0.01) for all factors, but the practical significance of activity level wasminimal. The ICCs were [inter](intra): KL [0.79] (0.84), patient management [0.54].Conclusion: When evaluating glenohumeral osteoarthritis, patient symptoms and KL grade are the factors moststrongly associated with treatment. In operative cases, the factors most strongly associated with the choice of operationwere the patient's KL grade and age. Additionally, the KL classification demonstrated excellent observer reliability.However, there was only moderate agreement among shoulder specialists regarding treatment, indicating that thisremains a controversial topic.Level of evidence: III |
| نویسندگان مقاله |
| Adam Schumaier
University of Cincinnati Department of Orthopaedics and
Sports Medicine, Cincinnati, Ohio, USA
| Joseph Abboud
Rothman Institute, Thomas Jefferson University,
Philadelphia, Pennsylvania, USA
| Brian Grawe
University of Cincinnati Department of Orthopaedics and
Sports Medicine, Cincinnati, Ohio, USA
| J. Gabriel Horneff
Rothman Institute, Thomas Jefferson University,
Philadelphia, Pennsylvania, USA
| Charles Getz
Rothman Institute, Thomas Jefferson University,
Philadelphia, Pennsylvania, USA
| Gerald Williams
Rothman Institute, Thomas Jefferson University,
Philadelphia, Pennsylvania, USA
| Matthew Ramsey
Rothman Institute, Thomas Jefferson University,
Philadelphia, Pennsylvania, USA
| Surena Namdari
Rothman Institute, Thomas Jefferson University,
Philadelphia, Pennsylvania, USA
| Anthony Romeo
Department of Orthopaedic Surgery, Rush University
Medical Center, Chicago, Illinois, USA
| Gregory Nicholson
Department of Orthopaedic Surgery, Rush University
Medical Center, Chicago, Illinois, USA
| Jay Keener
Department of Orthopaedic Surgery, Washington
University in St. Louis, St. Louis, Missouri, USA
| Richard Friedman
Department of Orthopaedic Surgery, Medical
University of South Carolina, Charleston, South
Carolina, USA
| Ed Yian
Department of Orthopaedics, Southern California
Permanente Medical Group, Anaheim, California, USA
| Stephanie Muh
Department of Orthopaedic Surgery, Henry Ford Hospital,
Detroit, Michigan, USA
| Ruth Delaney
University College Dublin, Dublin, Ireland
| Randall Otto
Premier Care Orthopaedics and Sports Medicine, St.
Louis, Missouri, USA
| William Levine
Department of Orthopaedic Surgery, Columbia University
Medical Center, New York, New York, USA
| JT Tokish
Steadman Hawkins Clinic of the Carolinas, Greenville
Health System, Greenville, South Carolina, USA
| Jack Kazanjian
Premier Orthopaedics, Havertown, Pennsylvania, USA
| Joshua Dines
Hospital for Special Surgery, New York, New York, USA
| Andrew Green
Department of Orthopaedic Surgery, Warren-Alpert
School of Medicine at Brown University, Providence,
Rhode Island
| Scott Paxton
Department of Orthopaedic Surgery, Warren-Alpert
School of Medicine at Brown University, Providence,
Rhode Island
| Brody Flanagin
Orthopaedic Associates of Dallas, Dallas, Texas, USA
| Samer Hasan
Cincinnati Sports Medicine, Cincinnati, Ohio, USA
| Scott Kaar
Department of Orthopaedic Surgery, Saint Louis
University, St. Louis, Missouri, USA
|