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

Alexander Brunner, MD
Department of Orthpaedics, University of Ulm

Benjamin Ulmar, MD
Department of Orthpaedics, University of Ulm

Heiko Reichel, MD, PhD
Department of Orthpaedics, University of Ulm

Ralf Decking, MD
Department of Orthpaedics, University of Ulm


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.

This article appears in HSS Journal: Volume 4, Number 1.
View the full article at springerlink.com.


About the HSS Journal
HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.

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