TY - JOUR
T1 - The Bonar score revisited
T2 - Region of evaluation significantly influences the standardized assessment of tendon degeneration
AU - FEARON, Angie
AU - Dahlstrom, Jane
AU - Twin, Jane
AU - Cook, Jill
AU - Scott, Alexander
N1 - Funding Information:
This study was funded by grants from the Canadian Institutes of Health Research and from WorksafeBC . Alex Scott was funded by a Clinical Scholar award from the Michael Smith Foundation for Health Research . The authors are grateful to Fiona Bonar for helpful advice in the evaluation of tendon degeneration.
PY - 2014
Y1 - 2014
N2 - Objectives: Tendinopathy is a common, costly condition affecting both sporting and sedentary populations. Research into tendinopathy frequently involves the evaluation of tendinosis, a pathology characterized by a lack of inflammatory cells, collagen disruption, neovascularisation, altered cell numbers and morphology and increased glycosaminoglycans. Evaluation of these characteristics can be undertaken using the Bonar histopathology score, but the characteristics are heterogeneous throughout tendon specimens with no standardized method of determining the area to be evaluated. The objective of this study was to assess whether the Bonar score varies depending on the criteria used to define the area of evaluation.
Design: Case series.
Methods: Two independent assessors, with a third to resolve disputes, evaluated 103 areas from 35 tendon specimens using the Bonar score. Specimens were scored once each in the area of worst collagen disruption, degree of vascularization, and cell morphological changes. The inter-tester reliability of the updated Bonar scale was good (r(2) = 0.71)
Results: The Bonar score was highest in the areas of worst cell morphological (CM) changes, followed by collagen disruption (CD) and lowest for the area of most extensive vascular proliferation (VS) (regression: CD vs. CM, p = 0.008, CM vs. VS, p < 0.001, CD vs. VS, p = 0.013). Suggested modifications to the Sonar score include the addition of a cellularity domain, specific definitions of hypo- and hypercellularity, and changes to the vascularity score to include pathological avascularity
AB - Objectives: Tendinopathy is a common, costly condition affecting both sporting and sedentary populations. Research into tendinopathy frequently involves the evaluation of tendinosis, a pathology characterized by a lack of inflammatory cells, collagen disruption, neovascularisation, altered cell numbers and morphology and increased glycosaminoglycans. Evaluation of these characteristics can be undertaken using the Bonar histopathology score, but the characteristics are heterogeneous throughout tendon specimens with no standardized method of determining the area to be evaluated. The objective of this study was to assess whether the Bonar score varies depending on the criteria used to define the area of evaluation.
Design: Case series.
Methods: Two independent assessors, with a third to resolve disputes, evaluated 103 areas from 35 tendon specimens using the Bonar score. Specimens were scored once each in the area of worst collagen disruption, degree of vascularization, and cell morphological changes. The inter-tester reliability of the updated Bonar scale was good (r(2) = 0.71)
Results: The Bonar score was highest in the areas of worst cell morphological (CM) changes, followed by collagen disruption (CD) and lowest for the area of most extensive vascular proliferation (VS) (regression: CD vs. CM, p = 0.008, CM vs. VS, p < 0.001, CD vs. VS, p = 0.013). Suggested modifications to the Sonar score include the addition of a cellularity domain, specific definitions of hypo- and hypercellularity, and changes to the vascularity score to include pathological avascularity
KW - Research methods
KW - Tendinopathy
KW - Collagen/ultrastructure
KW - Severity of Illness Index
KW - Reproducibility of Results
KW - Tendons/blood supply
KW - Humans
KW - Tendinopathy/pathology
KW - Observer Variation
UR - http://www.scopus.com/inward/record.url?scp=84902507371&partnerID=8YFLogxK
UR - http://www.mendeley.com/research/bonar-score-revisited-region-evaluation-significantly-influences-standardized-assessment-tendon-dege
U2 - 10.1016/j.jsams.2013.07.008
DO - 10.1016/j.jsams.2013.07.008
M3 - Article
C2 - 23932935
SN - 1440-2440
VL - 17
SP - 346
EP - 350
JO - Journal of Science and Medicine in Sport
JF - Journal of Science and Medicine in Sport
IS - 4
ER -