Evidence map›Paper›PMID 33330736›Full record

ArticleOrthopaedic journal of sports medicine2020

Interrater Agreement of an Arthroscopic Anterior Cruciate Ligament Tear Classification System.

BEAR-MOON, José F Vega, Gregory J Strnad, Isaac Briskin, Charles L Cox, Lutul D Farrow, Paul Fadale, David Flanigan, Michael Hulstyn, Peter B Imrey and 6 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Orthopaedic journal of sports medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03776162 (BEAR - MOON), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03776162 naactive not recruitingnot on this mapstarted 2021, after this paper: background citation

BEAR - MOON: A Two Arm Non-Inferiority Randomized Clinical Trial Comparing ACL Repair With BEAR Device vs. Autograft Patellar Tendon ACL Reconstruction

TypeinterventionalSponsorThe Cleveland ClinicRan2021 to 2027Enrolled150ConditionsAnterior Cruciate Ligament TearArmsACL Reconstruction (Bone Patellar Tendon Bone Graft), Bridge Enhanced ACL Restoration (BEAR)
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Reliability of Preoperative MRI in the Prediction of ACL Tear Type.Orthopaedic journal of sports medicine · 2025
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 1 institution in 1 country.

BEAR-MOON
José F VegaInvestigation performed at Cleveland Clinic, Cleveland, Ohio, USA.
Gregory J StrnadInvestigation performed at Cleveland Clinic, Cleveland, Ohio, USA.
Isaac BriskinInvestigation performed at Cleveland Clinic, Cleveland, Ohio, USA.
Charles L CoxInvestigation performed at Cleveland Clinic, Cleveland, Ohio, USA.
Lutul D FarrowInvestigation performed at Cleveland Clinic, Cleveland, Ohio, USA.
Paul FadaleInvestigation performed at Cleveland Clinic, Cleveland, Ohio, USA.
David FlaniganInvestigation performed at Cleveland Clinic, Cleveland, Ohio, USA.
Michael HulstynInvestigation performed at Cleveland Clinic, Cleveland, Ohio, USA.
Peter B ImreyInvestigation performed at Cleveland Clinic, Cleveland, Ohio, USA.
Christopher C KaedingInvestigation performed at Cleveland Clinic, Cleveland, Ohio, USA.
Brett D OwensInvestigation performed at Cleveland Clinic, Cleveland, Ohio, USA.
Paul SaluanInvestigation performed at Cleveland Clinic, Cleveland, Ohio, USA.
Rick WrightInvestigation performed at Cleveland Clinic, Cleveland, Ohio, USA.
Yi-Meng YenInvestigation performed at Cleveland Clinic, Cleveland, Ohio, USA.
Kurt P SpindlerInvestigation performed at Cleveland Clinic, Cleveland, Ohio, USA.
Cleveland Clinic · US

Funding

BEAR-MOON: A Two Arm Noninferiority Blinded Randomized Clinical Trial Comparing ACL Repair with BEAR Device vs. Standard of Care Autograft Patellar Tendon ACL ReconstructionR01AR074131 · NIAMS · CLEVELAND CLINIC LERNER COM-CWRU · PI SPINDLER, KURT PAUL · 2018 to 2024
$6.0M
NIAMS NIH HHS R01 AR074131
6 · The paper itself

Abstract

backgroundAnterior cruciate ligament (ACL) rupture is the most common ligament injury treated surgically by orthopaedic surgeons. The gold standard for the treatment of the majority of primary ACL tears is ACL reconstruction. However, novel methods of repair, such as bridge-enhanced ACL repair (BEAR), are currently being investigated as alternatives to reconstruction. To assess patients for midsubstance repair suitability, clarify the prognostic implications of injury location and damage, and evaluate the results of a repair technique, it is important to have a baseline classification system or grading scale that is reproducible across surgeons, particularly for multicenter collaboration. Currently, no such system or scale exists. PURPOSE: To develop an arthroscopic ACL tear classification system and to evaluate its interobserver reliability. STUDY

designCohort study (diagnosis); Level of evidence, 3.

methodsEleven fellowship-trained orthopaedic surgeon investigators reviewed 75 video clips containing arthroscopic evaluation of a torn ACL and then completed the 6-question ACL Pathology Evaluation Form. Agreement statistics including exact agreement, Fleiss κ, Gwet agreement coefficient 1 (AC1), and Gwet AC2 were then calculated to assess interobserver reliability.

resultsIn aggregate, the multiple assessments of observer reproducibility revealed that surgeon participants in this study, when evaluating the same injury, agreed roughly 80% of the time on whether (1) at least 50% of the tibial footprint remained, (2) the remaining tibial stump was ≥10 mm, and (3) the injury was therefore reparable using the BEAR procedure. Participants also agreed roughly 60% of the time on exactly how many suturable bundles were available. These characteristics are believed to be most important, among those studied, in determining whether a torn ACL is amenable to midsubstance repair.

conclusionThis study is the first of its kind to demonstrate the interobserver reliability of arthroscopic classification of ACL tears. We have demonstrated that this classification system, though not ideally reproducible, is reliable enough across surgeons at multiple institutions for use in multicenter studies. REGISTRATION: NCT03776162 (ClinicalTrials.gov identifier).

Indexed as

ACL reconstructionACL repairACL tearinterrater agreementmidsubstance repairreliability

Identifiers

PMID33330736
PMCPMC7720329
OpenAlexW3107130063

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.