Observer Variability of Arthroscopic Cartilage Grading Using the Modified Outerbridge Classification System in the...

Area of Science:

• Veterinary Orthopedics
• Surgical Pathology
• Diagnostic Imaging

Background:

• Accurate cartilage assessment is crucial for diagnosing canine joint disease.
• The modified Outerbridge system is widely used but its reliability in canine arthroscopy requires validation.

Purpose of the Study:

• To assess the inter- and intra-observer variability of the modified Outerbridge cartilage classification system.
• To evaluate the impact of observer experience on scoring reliability in canine arthroscopy.

Main Methods:

• Fifty arthroscopic videos of canine cartilage were evaluated by six observers with varying experience levels.
• Kappa (κ) statistics were employed to quantify inter- and intra-observer agreement.
• Landis and Koch criteria were used to interpret agreement strength.

Main Results:

• The modified Outerbridge system demonstrated fair inter-observer and substantial intra-observer agreement.
• Scores of 0 and 4 showed higher agreement than intermediate scores (1-3).
• Increased observer experience significantly improved agreement strength.

Conclusions:

• The modified Outerbridge classification is a reliable tool for canine cartilage evaluation via arthroscopy.
• Observer experience and consistent application by the same individual enhance diagnostic accuracy.
• Standardized training may further improve the reliability of this classification system.