Ottawa classification for symptomatic acetabular dysplasia assessment of interobserver and intraobserver reliability

Bone & Joint Research

article

K. Bali¹  K. Smit²  M. Ibrahim¹  S. Poitras³  G. Wilkin¹  R. Galmiche¹  E. Belzile⁴  P. E. Beaulé⁵ 

[1] Division of Orthopaedic Surgery, Faculty of Medicine, University of Ottawa, The Ottawa Hospital;Division of Orthopaedic Surgery, Children’s Hospital of Eastern Ontario;Physiotherapy Program, School of Rehabilitation, Faculty of Health Sciences, University of Ottawa;Division of Orthopaedic Surgery, University of Laval;University of Ottawa;Head, Division of Orthopaedic Surgery, The Ottawa Hospital

关键词: Hip dysplasia;    Lateral centre edge angle;    Retroversion;    Classification;    Periacetabular osteotomy;   

DOI  :  10.1302/2046-3758.95.BJR-2019-0155.R1

学科分类：骨科学

来源: British Editorial Society Of Bone And Joint Surgery

【 摘 要 】

AimsThe aim of the current study was to assess the reliability of the Ottawa classification for symptomatic acetabular dysplasia.MethodsIn all, 134 consecutive hips that underwent periacetabular osteotomy were categorized using a validated software (Hip2Norm) into four categories of normal, lateral/global, anterior, or posterior. A total of 74 cases were selected for reliability analysis, and these included 44 dysplastic and 30 normal hips. A group of six blinded fellowship-trained raters, provided with the classification system, looked at these radiographs at two separate timepoints to classify the hips using standard radiological measurements. Thereafter, a consensus meeting was held where a modified flow diagram was devised, before a third reading by four raters using a separate set of 74 radiographs took place.ResultsIntrarater results per surgeon between Time 1 and Time 2 showed substantial to almost perfect agreement among the raters (κappa = 0.416 to 0.873). With respect to inter-rater reliability, at Time 1 and Time 2 there was substantial agreement overall between all surgeons (Time 1 κappa = 0.619; Time 2 κappa = 0.623). Posterior and anterior rating categories had moderate and fair agreement at Time 1 (posterior κappa = 0.557; anterior κappa = 0.438) and Time 2 (posterior κappa = 0.506; anterior κappa = 0.250), respectively. At Time 3, overall reliability (κappa = 0.687) and posterior and anterior reliability (posterior κappa = 0.579; anterior κappa = 0.521) improved from Time 1 and Time 2.ConclusionThe Ottawa classification system provides a reliable way to identify three categories of acetabular dysplasia that are well-aligned with surgical management. The term ‘borderline dysplasia’ should no longer be used.

【 授权许可】

CC BY-NC