Inter- and intra-observer agreement in arthroscopic assessment of the long head of the biceps

Abstract

IntroductionLong head of the biceps (LHB) pathology is frequent but can be difficult to diagnose. Arthroscopy is the current diagnostic gold-standard. The aim of the present study was to assess inter- and intra-observer agreement in arthroscopic analysis of the LHB. HypothesisAgreement in arthroscopic analysis of the LHB is good in the particular case of small rotator cuff tears. Material and methodsThis prospective study included 49 patients operated on between November 1 and November 30, 2017. Seven surgeons were asked to record videos of arthroscopic LHB analysis for Patte-1 small supraspinatus tendon tears. One junior and 2 senior surgeons analyzed the videos independently, studying macroscopic intrinsic and extrinsic LHB aspect. Inter-observer agreement, and intra-observer agreement for the junior surgeon, were analyzed. ResultsInter-observer agreement between the surgeons and intra-observer agreement for the junior surgeon were slight in describing the pathologic aspect of the LHB: respectively, κ=0.254, p<0.038; and κ=0.319, p<0.0019. DiscussionIsolated arthroscopic LHB assessment without clinical or paraclinical input or precise surgical exploration protocol showed slight inter-observer agreement. Analysis and interpretation of LHB aspect should in practice be based on combined clinical, paraclinical and arthroscopic data. Level of evidenceIII.