Article ; Online: Evaluation of a modified radiographic union scale for tibial fractures scoring system in staged bilateral tibial plateau leveling osteotomy procedures and comparison of first and second side radiographic bone healing
Veterinary Surgery. 2022 Nov., v. 51, no. 8 p.1231-1239
2022
Abstract: OBJECTIVE: To evaluate the inter‐ and intra‐rater reliability of the tibial plateau leveling osteotomy (TPLO) modified radiographic union scale for tibial fractures (mRUST), a semiquantitative scoring system, as compared with the subjective evaluation of ...
| Abstract | OBJECTIVE: To evaluate the inter‐ and intra‐rater reliability of the tibial plateau leveling osteotomy (TPLO) modified radiographic union scale for tibial fractures (mRUST), a semiquantitative scoring system, as compared with the subjective evaluation of radiographic union for staged TPLOs. STUDY DESIGN: Retrospective study. ANIMALS: Forty‐eight dogs, 96 stifles. METHODS: Medical records were reviewed for dogs with bilateral cranial cruciate ligament injuries diagnosed at presentation that underwent staged bilateral TPLOs within 6 months and had both immediate and recheck postoperative radiographs. Radiographs were anonymized, reviewers were blinded, radiographic union was evaluated subjectively, and TPLO mRUST scores were assigned. RESULTS: The subjective evaluation's intra‐rater reliability was 0.72 (Kappa 95% CI 0.65‐0.79) and inter‐rater reliability was 0.33 (Kappa 95% CI 0.28‐0.39). The TPLO mRUST scoring system intra‐rater reliability was 0.73 (95% CI 0.68‐0.78) and inter‐rater reliability was 0.56 (95% CI 0.41‐0.68). There was no difference in the degree of bone healing quantified by the TPLO mRUST scoring system (95% CI ‐ 0.1‐1.2, P = .09) or subjective evaluation (P = .48) between the first and second side TPLOs. The TPLO mRUST scores were positively correlated with subjective healing (r = 0.94, 95% CI 0.92‐0.96, P < .0001, and for scores ≥10/12, 99%, 244/246) were subjectively assigned as radiographically healed. CONCLUSION: The TPLO mRUST scoring system improved inter‐rater reliability compared to subjective evaluation of radiographic union. CLINICAL SIGNIFICANCE: The TPLO mRUST scoring system should be considered as a semiquantitative supplemental tool for evaluating radiographic union. |
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| Keywords | cranial cruciate ligament ; osteotomy ; radiography ; retrospective studies ; tibia |
| Language | English |
| Dates of publication | 2022-11 |
| Size | p. 1231-1239. |
| Publishing place | John Wiley & Sons, Inc. |
| Document type | Article ; Online |
| Note | JOURNAL ARTICLE |
| ZDB-ID | 1491071-8 |
| ISSN | 1532-950X ; 0161-3499 |
| ISSN (online) | 1532-950X |
| ISSN | 0161-3499 |
| DOI | 10.1111/vsu.13873 |
| Database | NAL-Catalogue (AGRICOLA) |
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