How Well do Orthopedic Surgeons Recognize Different Models of Total Elbow Arthroplasties on Plain Radiographs with the Use of a Diagnostic Flowchart?

Document Type : RESEARCH PAPER

Authors

1 Department of Orthopedic Surgery, Amhpia Hospital, Molengracht 21, 4818CK Breda, the Netherlands

2 Department of Orthopedic Surgery, AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands

3 Department of Orthopedic Surgery, Rijnstate Hospital, Wagnerlaan 55, 6815 AD Arnhem, the Netherlands

4 Department of Orthopedic and Trauma Surgery, OLVG, Oosterpark 9, 1091 AC Amsterdam, the Netherlands

5 Department of Orthopedic Surgery, Amhpia Hospital, Molengracht 21, 4818CK Breda, the Netherlands Department of Orthopedic Surgery, AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands

Abstract

Background: Recognition of total elbow arthroplasties (TEAs) on plain radiographs is difficult due to a multitude of
different types and models. Especially if surgery reports and documentation are not available, lost or when the primary
surgery was performed in another hospital the prosthesis type may be undeterminable. Therefore we investigated
in this platform study if a flowchart aids in recognition of thirteen different total elbow arthroplasty models on plain
radiographs.
Methods: An online questionnaire on the Shoulder and Elbow Platform was developed. Plain radiographs of thirteen
TEA models were shown with and without the help of an especially developed flowchart describing distinguishing
features.
Results: Ten orthopedic surgeons specialized in upper extremity surgery completed the study. Recognition rates of the
thirteen total elbow arthroplasty models ranged between 20 and 100 percent without the flowchart. Using the flowchart
recognition varied between 40 and 90 percent. The recognition rates with the flowchart were not significantly higher.
Inter-observer reliability did not increase on a significant level.
Conclusion: Correct recognition of total elbow arthroplasty models with plain radiographs remains imperfect with our
developed flowchart. The flowchart increased correct recognition rates and inter-observer reliability.
Level of evidence: II

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Main Subjects

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Arch Bone Jt Surg. 2019; 7(2):191.
The Archives of Bone and Joint Surgery
Volume 7, Issue 5
September 2019
Pages 407-415

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History

  • Receive Date: 11 April 2018
  • Revise Date: 05 October 2018
  • Accept Date: 17 December 2018

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