Purpose
The purpose of this study was to determine whether standardized measurements are more
reliable than mere estimation in determining the extent of the defect in reverse Hill-Sachs
lesions.
Methods
Twelve patients with 13 reverse Hill-Sachs lesions and available computed tomographic
scans were included in this study. Based on the computed tomographic scans, estimation
and measurement of the defect size in reverse Hill-Sachs lesions using a novel standardized
method were carried out twice by 6 observers (3 experts and 3 residents), with an
interval of 3 months between observations. To assess and compare the reliability of
the estimation of the defect size and the measurement of the defect size, intraclass
correlation coefficients were computed.
Results
Estimation of the defect size showed a low interobserver reliability of 0.61 (95%
confidence interval [CI], 0.38 to 0.83) and 0.47 (95% CI, 0.24 to 0.74) and a moderate
intraobserver reliability of 0.71 (95% CI, 0.51 to 0.89). The estimations of the different
observers showed statistically significant differences (P < .001). The standardized measurements reached high interobserver reliability (at
least ≥0.81) and excellent intraobserver reliability (at least ≥0.88). Residents provided
less reliable estimations compared with experts; however, they obtained similarly
high reliability when applying the standardized measurements.
Conclusions
The mere estimation of the size of reverse Hill-Sachs lesions showed poor reliability,
raising the concern for potential overestimation or underestimation in clinical practice.
Standardized measurements, which showed good reliability, should be used whenever
analyzing the size of a reverse Hill-Sachs defect.
Level of Evidence
Level IV, diagnostic case series.
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Article info
Publication history
Published online: January 24, 2013
Accepted:
October 18,
2012
Received:
June 7,
2012
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
