Can the MRI based AMADEUS score accurately assess pre‐surgery chondral defect severity according to the ICRS arthroscopic classification system?
Abstract Purpose The AMADEUS (Area Measurement And DEpth and Underlying Structures) scoring and grading system has been proposed for the MRI based evaluation of untreated focal chondral defects around the knee. The clinical practicability, its correlation with arthroscopically assessed grading syste...
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Wiley
2022-01-01
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| Series: | Journal of Experimental Orthopaedics |
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| Online Access: | https://doi.org/10.1186/s40634-022-00511-w |
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| author | Tizian Heinz Felix Meller Karsten Sebastian Luetkens Konstantin Horas Thomas Schäfer Maximilian Rudert Stephan Reppenhagen Manuel Weißenberger |
| author_facet | Tizian Heinz Felix Meller Karsten Sebastian Luetkens Konstantin Horas Thomas Schäfer Maximilian Rudert Stephan Reppenhagen Manuel Weißenberger |
| author_sort | Tizian Heinz |
| collection | DOAJ |
| description | Abstract Purpose The AMADEUS (Area Measurement And DEpth and Underlying Structures) scoring and grading system has been proposed for the MRI based evaluation of untreated focal chondral defects around the knee. The clinical practicability, its correlation with arthroscopically assessed grading systems (ICRS – International Cartilage Repair Society) and thereby its clinical value in terms of decision making and guiding prognosis was yet to determine. Methods From 2008 to 2019 a total of 89 individuals were indicated for high tibial valgus osteotomy (HTO) due to tibial varus deformity and concomitant chondral defects of the medial compartment of the knee. All patients received a preoperative MRI (1.5 Tesla or 3.0 Tesla) and pre‐osteotomy diagnostic arthroscopy. Chondral defects of the medial compartment were scored and graded with the MRI based AMADEUS by three independent raters and compared to arthroscopic defect grading by the ICRS system. Interrater and intrarater reliability as well as correlation analysis with the ICRS classification system were assessed. Results Intraclass correlation coefficients for the various subscores of the AMADEUS showed an overall good to excellent interrater agreement (min: 0.26, max: 0.80). Intrarater agreement turned out to be substantially inferior (min: 0.08, max: 0.53). Spearman correlation revealed an overall moderate correlative association of the AMADEUS subscores with the ICRS classification system, apart from the defect area subscore. Sensitivity of the AMADEUS to accurately identify defect severity according to the ICRS was 0.7 (0.69 for 3.0 Tesla MRI, 0.67 for 1.5 Tesla MRI). The mean AMADEUS grade was 2.60 ± 0.81 and the mean ICRS score 2.90 ± 0.63. Conclusions Overall, the AMADEUS with all its subscores shows moderate correlation with the arthroscopic chondral grading system according to ICRS. This suggests that chondral defect grading by means of the MRI based AMADEUS is well capable of influencing and guiding treatment decisions. Interrater reliability shows overall good agreement. |
| format | Article |
| id | doaj-art-67c23c2eab7442af9fafef0a01debc06 |
| institution | DOAJ |
| issn | 2197-1153 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
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| series | Journal of Experimental Orthopaedics |
| spelling | doaj-art-67c23c2eab7442af9fafef0a01debc062025-08-20T03:07:37ZengWileyJournal of Experimental Orthopaedics2197-11532022-01-0191n/an/a10.1186/s40634-022-00511-wCan the MRI based AMADEUS score accurately assess pre‐surgery chondral defect severity according to the ICRS arthroscopic classification system?Tizian Heinz0Felix Meller1Karsten Sebastian Luetkens2Konstantin Horas3Thomas Schäfer4Maximilian Rudert5Stephan Reppenhagen6Manuel Weißenberger7Department of Orthopaedic SurgeryUniversity of WuerzburgKoenig‐Ludwig‐HausBrettreichstr 1197074WuerzburgGermanyDepartment of Orthopaedic SurgeryUniversity of WuerzburgKoenig‐Ludwig‐HausBrettreichstr 1197074WuerzburgGermanyDepartment of Diagnostic and Interventional RadiologyUniversity Hospital WuerzburgOberduerrbacherstr 697080WuerzburgGermanyDepartment of Orthopaedic SurgeryUniversity of WuerzburgKoenig‐Ludwig‐HausBrettreichstr 1197074WuerzburgGermanyDepartment of Orthopaedic SurgeryUniversity of WuerzburgKoenig‐Ludwig‐HausBrettreichstr 1197074WuerzburgGermanyDepartment of Orthopaedic SurgeryUniversity of WuerzburgKoenig‐Ludwig‐HausBrettreichstr 1197074WuerzburgGermanyDepartment of Orthopaedic SurgeryUniversity of WuerzburgKoenig‐Ludwig‐HausBrettreichstr 1197074WuerzburgGermanyDepartment of Orthopaedic SurgeryUniversity of WuerzburgKoenig‐Ludwig‐HausBrettreichstr 1197074WuerzburgGermanyAbstract Purpose The AMADEUS (Area Measurement And DEpth and Underlying Structures) scoring and grading system has been proposed for the MRI based evaluation of untreated focal chondral defects around the knee. The clinical practicability, its correlation with arthroscopically assessed grading systems (ICRS – International Cartilage Repair Society) and thereby its clinical value in terms of decision making and guiding prognosis was yet to determine. Methods From 2008 to 2019 a total of 89 individuals were indicated for high tibial valgus osteotomy (HTO) due to tibial varus deformity and concomitant chondral defects of the medial compartment of the knee. All patients received a preoperative MRI (1.5 Tesla or 3.0 Tesla) and pre‐osteotomy diagnostic arthroscopy. Chondral defects of the medial compartment were scored and graded with the MRI based AMADEUS by three independent raters and compared to arthroscopic defect grading by the ICRS system. Interrater and intrarater reliability as well as correlation analysis with the ICRS classification system were assessed. Results Intraclass correlation coefficients for the various subscores of the AMADEUS showed an overall good to excellent interrater agreement (min: 0.26, max: 0.80). Intrarater agreement turned out to be substantially inferior (min: 0.08, max: 0.53). Spearman correlation revealed an overall moderate correlative association of the AMADEUS subscores with the ICRS classification system, apart from the defect area subscore. Sensitivity of the AMADEUS to accurately identify defect severity according to the ICRS was 0.7 (0.69 for 3.0 Tesla MRI, 0.67 for 1.5 Tesla MRI). The mean AMADEUS grade was 2.60 ± 0.81 and the mean ICRS score 2.90 ± 0.63. Conclusions Overall, the AMADEUS with all its subscores shows moderate correlation with the arthroscopic chondral grading system according to ICRS. This suggests that chondral defect grading by means of the MRI based AMADEUS is well capable of influencing and guiding treatment decisions. Interrater reliability shows overall good agreement.https://doi.org/10.1186/s40634-022-00511-wKneeCartilage defectGrading system of chondral defectsAMADEUSICRSMRI |
| spellingShingle | Tizian Heinz Felix Meller Karsten Sebastian Luetkens Konstantin Horas Thomas Schäfer Maximilian Rudert Stephan Reppenhagen Manuel Weißenberger Can the MRI based AMADEUS score accurately assess pre‐surgery chondral defect severity according to the ICRS arthroscopic classification system? Journal of Experimental Orthopaedics Knee Cartilage defect Grading system of chondral defects AMADEUS ICRS MRI |
| title | Can the MRI based AMADEUS score accurately assess pre‐surgery chondral defect severity according to the ICRS arthroscopic classification system? |
| title_full | Can the MRI based AMADEUS score accurately assess pre‐surgery chondral defect severity according to the ICRS arthroscopic classification system? |
| title_fullStr | Can the MRI based AMADEUS score accurately assess pre‐surgery chondral defect severity according to the ICRS arthroscopic classification system? |
| title_full_unstemmed | Can the MRI based AMADEUS score accurately assess pre‐surgery chondral defect severity according to the ICRS arthroscopic classification system? |
| title_short | Can the MRI based AMADEUS score accurately assess pre‐surgery chondral defect severity according to the ICRS arthroscopic classification system? |
| title_sort | can the mri based amadeus score accurately assess pre surgery chondral defect severity according to the icrs arthroscopic classification system |
| topic | Knee Cartilage defect Grading system of chondral defects AMADEUS ICRS MRI |
| url | https://doi.org/10.1186/s40634-022-00511-w |
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