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Visual Joint Angle Assessment: Does Accuracy Improve with a Higher Level of Orthopaedic Surgery Training?
Edward J Testa1, Joseph A Gil1, Nikita Lakomkin1
1Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI.
Introduction:
The purpose of this study was to evaluate the accuracy of visual joint angle assessments by orthopaedic surgery trainees amongst various levels of training.
Methods:
Sagittal plane photographs of several joints at various angles were distributed to trainees within an orthopaedic residency program. Joint angles were estimated and compared to those obtained with a goniometer. Inter-and intra-rater reliability and ANOVA were conducted to assess differences between groups.
Results:
Twenty trainees were studied. The percent error for knee measurements differed at 23.1%, 26.2% and 11.1% for the PGY 2-3, PGY 4-5 and PGY 6 groups, respectively (P=0.024). Percentage error for ankles showed the greatest variability at 69.7-96.3%. Intra-rater reliabilities for all visual joint angle assessment were similar amongst groups.
Conclusions:
Visual joint angle assessments vary amongst trainees, with PGY 6s most accurately identifying knee joint angles. Visual assessment is inaccurate compared to goniometric measurements, thus limiting visual measurements during patient encounters.
