The Kellgren-Lawrence Grading Scale: Development of An Online Training Tutorial

Background/ObjectiveKnee osteoarthritis (OA) is a degenerative form of arthritis characterized by skeletal changes, including osteophyte formation and joint space narrowing. In research, these changes are visualized by radiography, and the severity of radiographic OA is nearly always reported in terms of the semi-quantitative (0–4 point) Kellgren-Lawrence (KL) grading scale. However, several studies have documented unsatisfactory inter- and intra-rater reliability of the KL grading scale. Therefore, the purpose of this study was to develop a training module to improve the reliability of this common, but highly subjective, tool. MethodsA 30-minute training module was developed in an e-learning authoring tool, Articulate Presenter. This experimental module included information related to 1) the history of the KL grading scale and its relatively poor reliability, 2) the normal anatomy of a knee as pictured on a radiograph and, 3) examples of each of the KL grades with detailed descriptions of the correspondi...