The Reliability of Acromioclavicular Joint Dislocation Classification Systems: A Comparison Between the Rockwood and Kraus Classifications

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dc.contributor.authorVelasquez Garcia, Ausberto
dc.contributor.authorLiendo, Rodrigo
dc.contributor.authorEkdahl, Max
dc.contributor.authorCalvo, Cristobal
dc.contributor.authorVidal, Catalina
dc.date.accessioned2025-01-20T20:17:47Z
dc.date.available2025-01-20T20:17:47Z
dc.date.issued2023
dc.description.abstractBackground:The Rockwood system for the classification of acute acromioclavicular (AC) joint dislocations has been associated with a lack of reliability. A novel system has been proposed (Kraus classification) that is based on dynamic posterior translation of these injuries. Purpose:To assess the interobserver and intraobserver reliability of the Rockwood and Kraus classification systems and also to examine the impact of surgeon experience on the assessments. Study Design:Cohort study (diagnosis); Level of evidence, 3. Methods:Included were 45 patients with acute AC joint injuries who underwent a radiographic examination using standard bilateral AP and modified Alexander views. For interobserver reliability, 6 shoulder surgeons (expert group) and 6 orthopaedic residents (novice group) reviewed the radiographs to classify injuries according to the Rockwood and Kraus classifications; for each categorization, the participants chose between nonoperative management and surgical treatment. The evaluation was repeated 6 weeks later to determine intraobserver reliability. Kappa (kappa) coefficients and their 95% CIs were used to compare interobserver and intraobserver reliability for each classification system according to assessor experience. Statistical differences were considered significant when the upper and lower boundaries of the 95% CI did not overlap. Results:The overall interobserver agreement for diagnosis (both novice and expert groups) was moderate (kappa = 0.52 [95% CI, 0.51-0.54]) for the Rockwood classification and substantial (kappa = 0.62 [95% CI, 0.53-0.65]) for the Kraus classification; however, no significant differences were observed between the kappa values. The overall interobserver agreement for treatment selection was substantial when using both the Rockwood (kappa = 0.78 [95% CI, 0.72-0.81]) and Kraus (kappa = 0.77 [95% CI, 0.66-0.87]) classifications. The overall intraobserver agreement for diagnosis was substantial using both the Rockwood (kappa = 0.65 [95% CI, 0.61-0.67]) and Kraus (kappa = 0.73 [95% CI, 0.69-0.75]) classifications. There were no significant differences between the novice and expert groups on any of the evaluations. Conclusion:The Kraus system was slightly more reliable than the Rockwood system for classifying AC joint injuries both between assessor groups and overall. The level of surgeon experience had no impact on the evaluations.
dc.fuente.origenWOS
dc.identifier.doi10.1177/23259671221149391
dc.identifier.eissn2325-9671
dc.identifier.urihttps://doi.org/10.1177/23259671221149391
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/92420
dc.identifier.wosidWOS:000934701400001
dc.issue.numero2
dc.language.isoen
dc.revistaOrthopaedic journal of sports medicine
dc.rightsacceso restringido
dc.subjectacromioclavicular joint dislocation
dc.subjectRockwood classification
dc.subjectKraus classification
dc.subjectdynamic posterior translation
dc.subjectreliability of acromioclavicular classification
dc.titleThe Reliability of Acromioclavicular Joint Dislocation Classification Systems: A Comparison Between the Rockwood and Kraus Classifications
dc.typeartículo
dc.volumen11
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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