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The Teitge test.

Rikke Dyhr Hansen1, Jørgen Haraszuk1, Robert Allan Teitge2

  • 1Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital - Amager and Hvidovre Hospital, Denmark.

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|January 3, 2025
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The Teitge test for high tibial osteotomy (HTO) showed fair interrater reliability (κ = 0.33) among orthopedic surgeons. This suggests caution when using the Teitge test for absolute decision-making in treating knee osteoarthritis (OA).

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Area of Science:

  • Orthopedics
  • Knee Surgery
  • Osteoarthritis Research

Background:

  • High tibial osteotomy (HTO) is a surgical procedure to treat medial knee osteoarthritis (OA).
  • A clinical test, the Teitge test, was proposed to identify patients who would benefit from HTO.
  • Investigating the reliability of this test is crucial for its clinical application.

Purpose of the Study:

  • To assess the interrater reliability of the Teitge test in patients with medial knee OA.
  • To determine if the Teitge test can consistently yield the same results when performed by different experienced surgeons.
  • To evaluate the utility of the Teitge test in the decision-making process for HTO.

Main Methods:

  • A reliability study involving two experienced orthopedic surgeons.
  • The Teitge test includes varus and valgus stress tests to assess pain provocation and relief.
  • Inclusion criteria: medial knee OA (Kellgren-Lawrence grade 2-3), medial joint line pain, varus malalignment > 5 degrees.
  • Reliability was measured using Cohen's kappa (κ).

Main Results:

  • Eighteen patients were included in the study.
  • Initial agreement between surgeons was found in 12 out of 18 cases (κ = 0.22).
  • A prevalence and bias-adjusted kappa (κ = 0.33) was calculated due to an uneven distribution of positive test results.

Conclusions:

  • The Teitge test demonstrated fair interrater reliability.
  • The study does not recommend the Teitge test for absolute decision-making in HTO.
  • Clinicians should exercise caution when interpreting the Teitge test results due to low interrater agreement.