Skip to main content
Top
Published in: HSS Journal ® 1/2008

01-02-2008 | Original Article

The Eftekhar and Kerboul classifications in assessment of developmental dysplasia of the hip in adult patients. Measurement of inter- and intraobserver reliability

Authors: Alexander Brunner, MD, Benjamin Ulmar, MD, Heiko Reichel, MD, Ph.D., Ralf Decking, MD

Published in: HSS Journal ® | Issue 1/2008

Login to get access

Abstract

Aim

To measure the inter- and intraobserver reliability of two radiologic classification systems in the evaluation of severity of osteoarthritis secondary to developmental dysplasia of the hip in adult patients and to compare these systems to historically published data on two more commonly used classification systems described by Crowe and by Hartofikakidis.

Material and methods

Eighty-six dysplastic hips on 66 anteroposterior standard pelvic x-rays were rated according to the criteria of Eftekhar and Kerboul by three observers with different levels of clinical training. To assess intraobserver reliability, the measurement was repeated 3 months later. Statistical analysis was performed by calculating the weighted kappa correlation coefficient and the overall kappa coefficient.

Results

Both classification systems showed a sufficient interobsever reliability, reaching a kappa coefficient of 0.73 for the system according to Eftekhar and 0.716 for the Kerboul classification system. Intraobserver reliability revealed a kappa coefficient of 0.778 for the Eftekhar system and 0.697 for the classification according to Kerboul.

Conclusion

Both systems showed good inter- and intraobserver reliability for use in daily practice. However, they did not reach the known reliability of the grading systems published by Crowe and by Hartofikakidis. Because these systems are more frequently used, we would recommend one of them to grade the severity of osteoarthritis secondary to developmental dysplasia of the hip in adult patients instead of the ones described by Eftekhar or by Kerboul.
Literature
1.
go back to reference Solomon L, Schnitzler CM (1983) Pathogenetic types of coxarthrosis and implications for treatment. Arch Orthop Trauma Surg 101:259–261PubMedCrossRef Solomon L, Schnitzler CM (1983) Pathogenetic types of coxarthrosis and implications for treatment. Arch Orthop Trauma Surg 101:259–261PubMedCrossRef
2.
go back to reference Gunther KP, Sturmer T, Trepte CT, et al. (1999) Incidence of joint-specific risk factors in patients with advanced cox- and gonarthroses in the Ulm Osteoarthrosis Study. Z Orthop Ihre Grenzgeb 137:468–473PubMedCrossRef Gunther KP, Sturmer T, Trepte CT, et al. (1999) Incidence of joint-specific risk factors in patients with advanced cox- and gonarthroses in the Ulm Osteoarthrosis Study. Z Orthop Ihre Grenzgeb 137:468–473PubMedCrossRef
3.
go back to reference Paavilainen T (1997) Total hip replacement for developmental dysplasia of the hip. Acta Orthop Scand 68:77–84PubMed Paavilainen T (1997) Total hip replacement for developmental dysplasia of the hip. Acta Orthop Scand 68:77–84PubMed
4.
go back to reference Harris WH (1998) Total hip arthroplasty in the management of congenital hip dislocation. In: Callaghan JJ, Rosenberg AG, Rubash HE (eds) The adult hip. Linnicott-Raven, Philadelphia, pp 1165–1182 Harris WH (1998) Total hip arthroplasty in the management of congenital hip dislocation. In: Callaghan JJ, Rosenberg AG, Rubash HE (eds) The adult hip. Linnicott-Raven, Philadelphia, pp 1165–1182
5.
go back to reference Charnley J, Feagin JA (1973) Low-friction arthroplasty in congenital subluxation of the hip. Clin Orthop 91:98–113PubMedCrossRef Charnley J, Feagin JA (1973) Low-friction arthroplasty in congenital subluxation of the hip. Clin Orthop 91:98–113PubMedCrossRef
6.
go back to reference Decking R, Brunner A, Gunther KP, et al. (2006) Total hip arthroplasty in congenital dysplasia of the hip: follow-up of a small-dimensioned, cemented straight stem. Z Orthop Ihre Grenzgeb 144:380–385PubMedCrossRef Decking R, Brunner A, Gunther KP, et al. (2006) Total hip arthroplasty in congenital dysplasia of the hip: follow-up of a small-dimensioned, cemented straight stem. Z Orthop Ihre Grenzgeb 144:380–385PubMedCrossRef
7.
go back to reference Chandler HP, Reineck FT, Wixson RL, et al. (1981) Total hip replacement in patients younger than thirty years old. A five-year follow-up study. J Bone Joint Surg Am 63:1426–1434PubMed Chandler HP, Reineck FT, Wixson RL, et al. (1981) Total hip replacement in patients younger than thirty years old. A five-year follow-up study. J Bone Joint Surg Am 63:1426–1434PubMed
8.
go back to reference Collis DK (1984) Cemented total hip replacement in patients who are less than fifty years old. J Bone Joint Surg Am 66:353–359PubMed Collis DK (1984) Cemented total hip replacement in patients who are less than fifty years old. J Bone Joint Surg Am 66:353–359PubMed
9.
go back to reference Collis DK (1991) Long-term (twelve to eighteen-year) follow-up of cemented total hip replacements in patients who were less than fifty years old. A follow-up note. J Bone Joint Surg Am 73:593–597PubMed Collis DK (1991) Long-term (twelve to eighteen-year) follow-up of cemented total hip replacements in patients who were less than fifty years old. A follow-up note. J Bone Joint Surg Am 73:593–597PubMed
10.
go back to reference Cornell CN, Ranawat CS (1986) Survivorship analysis of total hip replacements. Results in a series of active patients who were less than fifty-five years old. J Bone Joint Surg Am 68:1430–1434PubMed Cornell CN, Ranawat CS (1986) Survivorship analysis of total hip replacements. Results in a series of active patients who were less than fifty-five years old. J Bone Joint Surg Am 68:1430–1434PubMed
11.
go back to reference Dorr LD, Takei GK, Conaty JP (1983) Total hip arthroplasties in patients less than forty-five years old. J Bone Joint Surg Am 65:474–479PubMed Dorr LD, Takei GK, Conaty JP (1983) Total hip arthroplasties in patients less than forty-five years old. J Bone Joint Surg Am 65:474–479PubMed
12.
go back to reference Halley DK, Wroblewski BM (1986) Long-term results of low-friction arthroplasty in patients 30 years of age or younger. Clin Orthop 211:43–50PubMed Halley DK, Wroblewski BM (1986) Long-term results of low-friction arthroplasty in patients 30 years of age or younger. Clin Orthop 211:43–50PubMed
13.
go back to reference Ivory JP, Kershaw CJ, Choudhry R, et al. (1994) Autophor cementless total hip arthroplasty for osteoarthrosis secondary to congenital hip dysplasia. J Arthroplasty 9:427–433PubMedCrossRef Ivory JP, Kershaw CJ, Choudhry R, et al. (1994) Autophor cementless total hip arthroplasty for osteoarthrosis secondary to congenital hip dysplasia. J Arthroplasty 9:427–433PubMedCrossRef
14.
go back to reference Chougle A, Hemmady MV, Hodgkinson JP (2005) Severity of hip dysplasia and loosening of the socket in cemented total hip replacement. A long-term follow-up. J Bone Joint Surg Br 87:16–20PubMed Chougle A, Hemmady MV, Hodgkinson JP (2005) Severity of hip dysplasia and loosening of the socket in cemented total hip replacement. A long-term follow-up. J Bone Joint Surg Br 87:16–20PubMed
15.
go back to reference Crowe JF, Mani VJ, Ranawat CS (1979) Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am 61:15–23PubMed Crowe JF, Mani VJ, Ranawat CS (1979) Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am 61:15–23PubMed
16.
go back to reference Eftekhar N (1978) Principles of total hip arthroplasty. C V Mosby, St. Louis, pp 437–455 Eftekhar N (1978) Principles of total hip arthroplasty. C V Mosby, St. Louis, pp 437–455
17.
go back to reference Hartofilakidis G, Stamos K, Ioannidis TT (1988) Low friction arthroplasty for old untreated congenital dislocation of the hip. J Bone Joint Surg Br 70:182–186PubMed Hartofilakidis G, Stamos K, Ioannidis TT (1988) Low friction arthroplasty for old untreated congenital dislocation of the hip. J Bone Joint Surg Br 70:182–186PubMed
18.
go back to reference Kerboul M, Mathieu M, Sauzieres P (1987) Total hip replacement for congenital dislocation of the hip. In: Postel M, Kerboul M, Evrard J, Courpied JP (eds) Total hip replacement. Springer, Berlin Heidelberg New York, pp 51–66 Kerboul M, Mathieu M, Sauzieres P (1987) Total hip replacement for congenital dislocation of the hip. In: Postel M, Kerboul M, Evrard J, Courpied JP (eds) Total hip replacement. Springer, Berlin Heidelberg New York, pp 51–66
19.
go back to reference Mendes DG, Said MS, Aslan K (1996) Classification of adult congenital hip dysplasia for total hip arthroplasty. Orthopedics 19:881–887PubMed Mendes DG, Said MS, Aslan K (1996) Classification of adult congenital hip dysplasia for total hip arthroplasty. Orthopedics 19:881–887PubMed
20.
go back to reference Anderson MJ, Harris WH (1999) Total hip arthroplasty with insertion of the acetabular component without cement in hips with total congenital dislocation or marked congenital dysplasia. J Bone Joint Surg Am 81:347–354PubMed Anderson MJ, Harris WH (1999) Total hip arthroplasty with insertion of the acetabular component without cement in hips with total congenital dislocation or marked congenital dysplasia. J Bone Joint Surg Am 81:347–354PubMed
21.
go back to reference Kerboul M. (1989) Implantation of a total prosthesis in the deformed hip–exemplified by congenital hip dislocation. Orthopade 18:397–417PubMed Kerboul M. (1989) Implantation of a total prosthesis in the deformed hip–exemplified by congenital hip dislocation. Orthopade 18:397–417PubMed
22.
go back to reference Knecht A, Witzleb WC, Beichler T, et al. (2004) Functional results after surface replacement of the hip: comparison between dysplasia and idiopathic osteoarthritis. Z Orthop Ihre Grenzgeb 142:279–285PubMedCrossRef Knecht A, Witzleb WC, Beichler T, et al. (2004) Functional results after surface replacement of the hip: comparison between dysplasia and idiopathic osteoarthritis. Z Orthop Ihre Grenzgeb 142:279–285PubMedCrossRef
23.
go back to reference Cicchelli D, Allison T (1971) A new procedure for assessing reliability of scoring EEG sleep recordings. Am J EEG Technol 11:101–109 Cicchelli D, Allison T (1971) A new procedure for assessing reliability of scoring EEG sleep recordings. Am J EEG Technol 11:101–109
24.
go back to reference Fleiss J (1981) Statistical methods for rates and proportions. Wiley, New York Fleiss J (1981) Statistical methods for rates and proportions. Wiley, New York
25.
go back to reference Landis J, Koch G (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174PubMedCrossRef Landis J, Koch G (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174PubMedCrossRef
26.
go back to reference Becker DA, Gustilo RB (1995) Double-chevron subtrochanteric shortening derotational femoral osteotomy combined with total hip arthroplasty for the treatment of complete congenital dislocation of the hip in the adult. Preliminary report and description of a new surgical technique. J Arthroplasty 10:313–318PubMedCrossRef Becker DA, Gustilo RB (1995) Double-chevron subtrochanteric shortening derotational femoral osteotomy combined with total hip arthroplasty for the treatment of complete congenital dislocation of the hip in the adult. Preliminary report and description of a new surgical technique. J Arthroplasty 10:313–318PubMedCrossRef
27.
go back to reference Cameron HU, Botsford DJ, Park YS (1996) Influence of the Crowe rating on the outcome of total hip arthroplasty in congenital hip dysplasia. J Arthroplasty 11:582–587PubMedCrossRef Cameron HU, Botsford DJ, Park YS (1996) Influence of the Crowe rating on the outcome of total hip arthroplasty in congenital hip dysplasia. J Arthroplasty 11:582–587PubMedCrossRef
28.
go back to reference Rasmussen S, Madsen PV, Bennicke K (1993) Observer variation in the Lauge–Hansen classification of ankle fractures. Precision improved by instruction. Acta Orthop Scand 64:693–694PubMedCrossRef Rasmussen S, Madsen PV, Bennicke K (1993) Observer variation in the Lauge–Hansen classification of ankle fractures. Precision improved by instruction. Acta Orthop Scand 64:693–694PubMedCrossRef
29.
go back to reference Sidor ML, Zuckerman JD, Lyon T, et al. (1993) The Neer classification system for proximal humeral fractures. An assessment of interobserver reliability and intraobserver reproducibility. J Bone Joint Surg Am 75:1745–1750PubMed Sidor ML, Zuckerman JD, Lyon T, et al. (1993) The Neer classification system for proximal humeral fractures. An assessment of interobserver reliability and intraobserver reproducibility. J Bone Joint Surg Am 75:1745–1750PubMed
30.
go back to reference Decking R, Brunner A, Decking J, et al. (2006) Reliability of the Crowe und Hartofilakidis classifications used in the assessment of the adult dysplastic hip. Skeletal Radiol 35:282–287PubMedCrossRef Decking R, Brunner A, Decking J, et al. (2006) Reliability of the Crowe und Hartofilakidis classifications used in the assessment of the adult dysplastic hip. Skeletal Radiol 35:282–287PubMedCrossRef
Metadata
Title
The Eftekhar and Kerboul classifications in assessment of developmental dysplasia of the hip in adult patients. Measurement of inter- and intraobserver reliability
Authors
Alexander Brunner, MD
Benjamin Ulmar, MD
Heiko Reichel, MD, Ph.D.
Ralf Decking, MD
Publication date
01-02-2008
Publisher
Springer-Verlag
Published in
HSS Journal ® / Issue 1/2008
Print ISSN: 1556-3316
Electronic ISSN: 1556-3324
DOI
https://doi.org/10.1007/s11420-007-9066-z

Other articles of this Issue 1/2008

HSS Journal ® 1/2008 Go to the issue