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Inter- and intra-observer variability of the Crowe and Hartofilakidis classification systems for congenital hip

C K Yiannakopoulos1, A Chougle, A Eskelinen

  • 1Nikis 2, 14561 Athens, Greece. cky@ath.forthnet.gr

The Journal of Bone and Joint Surgery. British Volume
|May 3, 2008
PubMed

Insights

The Crowe and Hartofilakidis classifications for developmental dysplasia of the hip show substantial to almost perfect reliability among experienced surgeons for adult hip osteoarthritis assessment.

Area of Science:

  • Orthopedics
  • Radiology
  • Surgical Assessment

Background:

  • Developmental dysplasia of the hip (DDH) is a common condition.
  • Accurate classification systems are crucial for treatment planning in adult hip osteoarthritis.
  • The Crowe and Hartofilakidis classifications are widely used for DDH.

Purpose of the Study:

  • To evaluate the inter- and intra-observer reliability of the Crowe and Hartofilakidis classification systems.
  • To assess the consistency of these classifications in adult hip osteoarthritis.
  • To compare the reliability of the two systems.

Main Methods:

  • Retrospective review of 209 pelvic radiographs from 145 adult patients with osteoarthritic hips.
  • Two independent assessments by three experienced hip surgeons from different European countries.
  • Application of both Crowe and Hartofilakidis classification systems.
  • Calculation of inter- and intra-observer agreement using weighted kappa coefficients.

Main Results:

  • Both Crowe and Hartofilakidis classifications demonstrated substantial to almost perfect reliability.
  • Interobserver reliability (kappa values) ranged from 0.85 to 0.93.
  • Intra-observer reliability (kappa values) ranged from 0.80 to 0.95.
  • High agreement was observed for both serial measurements by individual readers and between different readers.

Conclusions:

  • The Crowe and Hartofilakidis classification systems are reliable tools for assessing adult hip osteoarthritis.
  • Both systems provide consistent results among experienced surgeons.
  • The choice between systems may depend on the specific clinical information required, as they offer dissimilar data.

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