Introduction: High tibial osteotomy (HTO) is used to treat medial knee osteoarthritis (OA). A simple clinical test to select the patients most likely to benefit from the procedure was suggested by R. A. Teitge., MD, Professor Emeritus, a pioneer in osteotomies. This study aimed to investigate the interrater reliability of the Teitge test.
Methods: A reliability study was performed. The Teitge test consists of a varus stress test to provoke the patient's known symptoms, followed by a valgus stress test to simulate the realignment achieved by HTO. The test is considered positive if valgus stress relieves pain. Two experienced orthopaedic surgeons performed the test. The inclusion criteria were unicompartmental medial knee OA Kellgren-Lawrence type 2-3, pain at the medial joint line, varus malalignment > 5 degrees and English or Danish proficiency. Reliability was determined using Cohen's kappa (κ).
Results: A total of 18 patients, mean age (± SD) 56.7 (± 8.7), male/female 6/12 were included. Agreement was found in 12/18 cases, resulting in κ = 0.22 (95% confidence interval (CI): -0.29-0.72). Due to a weighted number of positive test results (11/18 and 15/18, respectively) a prevalence and bias-adjusted kappa was applied, reaching κ = 0.33 (95% CI: -0.1-0.77).
Conclusions: Fair agreement was found. We do not recommend the Teitge test for absolute decision-making, but it could be a valuable contributor to the complex mechanics of decision-making. Clinicians should be careful when interpreting the test due to the low interrater agreement.
Funding: None.
Trial registration: Not relevant.
Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.