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Radiographic evaluation of osteoarthritis of the hip: An inter-observer study of 61 hips treated for late-detected developmental hip dislocation

BACKGROUND AND PURPOSE: Different methods have been used to classify osteoarthritis (OA) of the hip. We evaluated the reliability of different classifications in order to find which grading system is most appropriate for use in clinical practice. PATIENTS AND METHODS: 49 patients (61 affected hips)...

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Autores principales: Terjesen, Terje, Gunderson, Ragnhild B
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Informa Healthcare 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3339535/
https://www.ncbi.nlm.nih.gov/pubmed/22329668
http://dx.doi.org/10.3109/17453674.2012.665331
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author Terjesen, Terje
Gunderson, Ragnhild B
author_facet Terjesen, Terje
Gunderson, Ragnhild B
author_sort Terjesen, Terje
collection PubMed
description BACKGROUND AND PURPOSE: Different methods have been used to classify osteoarthritis (OA) of the hip. We evaluated the reliability of different classifications in order to find which grading system is most appropriate for use in clinical practice. PATIENTS AND METHODS: 49 patients (61 affected hips) with late-detected developmental dislocation of the hip (DDH) were studied. The mean age at follow-up was 45 (32–49) years. 3 classifications of OA were compared. The gradings by Kellgren and Lawrence (1957) (K&L) and Croft et al. (1990) are global visual assessments based on osteophytes, cysts, subchondral sclerosis, and narrowing of the joint space. The third classification is based on narrowing in the upper, weight-bearing part of the joint and defines as OA a minimum joint space width (JSW) of less than 2.0 mm at the narrowest part. 2 experienced observers, one radiologist and one orthopedic surgeon, assessed and measured the radiographs. RESULTS: Minimum JSW (< 2.0 mm in 9 hips) gave the best inter-observer agreement (kappa value = 0.87). Using the K&L grading, inter-observer agreement was moderate (kappa = 0.55), but kappa increased when the number of categories was reduced from 5 to 3 (no OA, mild OA, and severe OA). The Croft classification gave similar agreement as the K&L grading. The intra-observer agreement was better than inter-observer agreement, irrespective of the grading system. There was a good accordance between the minimum JSW and the 2 other methods. INTERPRETATION: Joint space narrowing using a minimum JSW of < 2.0 mm as criterion for OA was the simplest and most reproducible classification in long-term follow-up of patients with DDH. A classification based on global visual assessment can be used in addition if only hips with severe OA are included.
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spelling pubmed-33395352012-05-03 Radiographic evaluation of osteoarthritis of the hip: An inter-observer study of 61 hips treated for late-detected developmental hip dislocation Terjesen, Terje Gunderson, Ragnhild B Acta Orthop Original Papers BACKGROUND AND PURPOSE: Different methods have been used to classify osteoarthritis (OA) of the hip. We evaluated the reliability of different classifications in order to find which grading system is most appropriate for use in clinical practice. PATIENTS AND METHODS: 49 patients (61 affected hips) with late-detected developmental dislocation of the hip (DDH) were studied. The mean age at follow-up was 45 (32–49) years. 3 classifications of OA were compared. The gradings by Kellgren and Lawrence (1957) (K&L) and Croft et al. (1990) are global visual assessments based on osteophytes, cysts, subchondral sclerosis, and narrowing of the joint space. The third classification is based on narrowing in the upper, weight-bearing part of the joint and defines as OA a minimum joint space width (JSW) of less than 2.0 mm at the narrowest part. 2 experienced observers, one radiologist and one orthopedic surgeon, assessed and measured the radiographs. RESULTS: Minimum JSW (< 2.0 mm in 9 hips) gave the best inter-observer agreement (kappa value = 0.87). Using the K&L grading, inter-observer agreement was moderate (kappa = 0.55), but kappa increased when the number of categories was reduced from 5 to 3 (no OA, mild OA, and severe OA). The Croft classification gave similar agreement as the K&L grading. The intra-observer agreement was better than inter-observer agreement, irrespective of the grading system. There was a good accordance between the minimum JSW and the 2 other methods. INTERPRETATION: Joint space narrowing using a minimum JSW of < 2.0 mm as criterion for OA was the simplest and most reproducible classification in long-term follow-up of patients with DDH. A classification based on global visual assessment can be used in addition if only hips with severe OA are included. Informa Healthcare 2012-04 2012-04-24 /pmc/articles/PMC3339535/ /pubmed/22329668 http://dx.doi.org/10.3109/17453674.2012.665331 Text en Copyright: © Nordic Orthopaedic Federation http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited.
spellingShingle Original Papers
Terjesen, Terje
Gunderson, Ragnhild B
Radiographic evaluation of osteoarthritis of the hip: An inter-observer study of 61 hips treated for late-detected developmental hip dislocation
title Radiographic evaluation of osteoarthritis of the hip: An inter-observer study of 61 hips treated for late-detected developmental hip dislocation
title_full Radiographic evaluation of osteoarthritis of the hip: An inter-observer study of 61 hips treated for late-detected developmental hip dislocation
title_fullStr Radiographic evaluation of osteoarthritis of the hip: An inter-observer study of 61 hips treated for late-detected developmental hip dislocation
title_full_unstemmed Radiographic evaluation of osteoarthritis of the hip: An inter-observer study of 61 hips treated for late-detected developmental hip dislocation
title_short Radiographic evaluation of osteoarthritis of the hip: An inter-observer study of 61 hips treated for late-detected developmental hip dislocation
title_sort radiographic evaluation of osteoarthritis of the hip: an inter-observer study of 61 hips treated for late-detected developmental hip dislocation
topic Original Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3339535/
https://www.ncbi.nlm.nih.gov/pubmed/22329668
http://dx.doi.org/10.3109/17453674.2012.665331
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