Interobserver and Intraobserver Error in Distal Femur Transepicondylar Axis Measurement With Computed Tomography

Abstract On 2 separate occasions at least 1 week apart, 6 independent observers studied errors in identification of the transepicondylar axis (TEA) using computed tomography in 10 cadaveric knees. The reference surgical TEA was established by dissection of specimens. We found an average error of 2.6...

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Bibliographic Details
Published in:The Journal of arthroplasty 2009, Vol.24 (1), p.96-100
Main Authors: Wai Hung, Chester Lie, MBBS, MRCSE, Wai Pan, Yau, FRCSE, FHKCOS, Kwong Yuen, Chiu, FRCSE, FHKCOS, Hon Bong, Leung, FRCSE, FHKCOS, Lei Sha, Lisa Wong, FRCR, FHKAM(Radiology), Ho Man, Simon Wong, MBBS
Format: Article
Language:English
Subjects:
Arthroplasty, Replacement, Knee
computed tomography
Femur - anatomy & histology
Femur - diagnostic imaging
Humans
Image Processing, Computer-Assisted - statistics & numerical data
Imaging, Three-Dimensional - statistics & numerical data
interobserver error
intraobserver error
Knee Joint - anatomy & histology
Knee Joint - diagnostic imaging
Observer Variation
Orthopedics
Radiography
Tomography Scanners, X-Ray Computed
total knee arthroplasty
transepicondylar axis
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Summary:Abstract On 2 separate occasions at least 1 week apart, 6 independent observers studied errors in identification of the transepicondylar axis (TEA) using computed tomography in 10 cadaveric knees. The reference surgical TEA was established by dissection of specimens. We found an average error of 2.6° (external rotation) when the TEA was identified by computed tomography. The error was significantly smaller when the TEA was identified by using a conventional axial image than when a 3-dimensional reconstruction image was used ( P < .001, paired t test). No significant intraobserver error ( P = .814, Wilcoxon rank test) was found when the measurement was performed using conventional 2-dimensional computed tomography images. However, significant interobserver difference was evident ( P < .001, Friedman test).
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2007.11.014