Interobserver reliability of the radiographic assessment of cement fixation in total hip arthroplasty
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Abdulaziz Al-Ahaideb1, S W Muir, J Huckell
1Department of Orthopaedics, College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Saudi Arabia, ahaideb@gmail.com.
Background:
The objective of this work is to evaluate the performance of a modified quantitative Barrack Cement grading in primary THA. Previous studies demonstrated both poor intraobserver and interobserver reliability which may be due to the qualitative nature of the scale.
Methods:
Interobserver reliability of the Barrack Cement Grading System in its original format and then in combination with a quantitative measurement of implant/cement lengths was evaluated on 50 immediate post-operative radiographs of primary cemented arthroplasties. Intraobserver reliability was also assessed on a sub-sample of radiographs. Three evaluators with different skill levels and specialty participated: an arthroplasty surgeon, an orthopaedic resident and a radiologist. Reliability was measured using a weighted kappa coefficient for paired comparisons among the evaluators.
Results:
Interobserver reliability was poor (κ < 0.10) for all pairings of the Barrack System. The modified quantitative system achieved slight (κ < 0.20) to poor reliability. Intraobserver reliability was dependent on the skill and specialty of the evaluator with maximal values achieved for the experienced arthroplasty surgeon using the modified quantitative system (κ = 0.62).
Conclusion:
Use of the modified scale may improve the reliability of ratings when used by individual experienced arthroplasty surgeons.
