Correlação inter-observador da classificação de falhas ósseas em artroplastia de joelho

Abstract

Objective: Considering the difficulty for classifying bone losses the present study was designed to analyze if the AORI classification based on pre-operative radiographies is consistent and reproducible between different orthopedic surgeons. Methods: Six orthopedists specialized in knee surgery were trained for the use of the classification based on radiographic evaluation. All the surgeons individually classified 26 pre operative knee radiographs. Results: There was a moderate (> 50%) matching of the classification in 24 of 26 cases in the femur and 22 of 26 in the tibia. A good matching (> 80%) was present in 12 of 26 cases in the femur and in 7 of 26 cases in the tibia. Conclusion: We observed that the AORI classification presented a moderate radiographic correlation between surgeons. Evidence of level III, Study of nonconsecutive patients; without consistently applied reference ''gold'' standard.

Megaprostheses in Nononcologic Hip and Knee Revision Arthroplasty

“…Bone loss in revision total knee arthroplasty (TKA) is a considerable challenge; however, there are published classification systems and proposed reconstructive algorithms to address these difficult situations (Figure 4). 11-13 Within the array of reconstructive options, megaprostheses replace the entire distal femur and proximal tibia when standard revision components such as augments, cones, and sleeves are not feasible (Figure 5). This is particularly necessary when it is not feasible to reconstruct the axial stability of the medial and lateral columns of the metaphyseal bone and when bone loss is proximal to the epicondyles.…”

“…Type III defects demonstrate deficient metaphyseal bone that comprises a major portion of either femoral condyle or tibial plateau, often with associated compromised collateral and patellar ligament attachments. Figures A and B were used with permission from Shafaghi et al, 13 adapted from Pécora et al, 12 and originally described by Engh. 11…”

“…Bone loss in revision total knee arthroplasty (TKA) is a considerable challenge; however, there are published 4). [11][12][13] Within the array of reconstructive options, megaprostheses replace the entire distal femur and proximal tibia when standard revision components such as augments, cones, and sleeves are not feasible (Figure…”

Valor da avaliação radiográfica pré-operatória dos defeitos ósseos no joelho nas revisões de artroplastia

“…This classification system is based on the findings after removing the components of total knee arthroplasty (20) , but it can also be estimated by means of preoperative radiographs, with a moderate correlation between surgeons (20,22) . This classification system is widely used among knee surgeons, and is considered one of the best available options for this type of assessment.…”

Value of Preoperative Radiographic Evaluations on Knee Bone Defects for Revision Arthroplasty

“…Engh 20 , 21 describes a classification system for bone defects in the knee developed at the Anderson Orthopaedic Research Institute (AORI). This classification system is based on the findings after removing the components of total knee arthroplasty (20) , but it can also be estimated by means of preoperative radiographs, with a moderate correlation between surgeons 20 , 22 . This classification system is widely used among knee surgeons, and is considered one of the best available options for this type of assessment.…”