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Functional Classification of Joints

Functional Classification of Joints

Functional Classification of Joints
The functional classification of joints is determined by the amount of mobility between the adjacent bones. Joints are functionally classified as a synarthrosis or immobile joint, an amphiarthrosis or slightly moveable joint, or as a diarthrosis, a freely moveable joint. Fibrous and cartilaginous joints can be functionally classified as either synarthroses or amphiarthroses, whereas all synovial joints are classified as diarthroses.
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Interobserver and Intraobserver Reliability of Classification Systems for Radiographic Complications After Radial

Ryan T Halvorson¹, Gopal R Lalchandani¹, Matthew F Cherches¹

¹Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA.

The Journal of Hand Surgery

|February 19, 2022

Summary

Reliability of elbow radiograph classifications after radial head arthroplasty (RHA) varies. While ordinal radiolucency is reliable, other systems like stress shielding (SS) and heterotopic ossification (HO) show limited agreement, necessitating cautious interpretation.

Keywords:

Heterotopic ossification radial head arthroplasty radiolucency reliability stress shielding

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Area of Science:

Orthopedic surgery
Radiology
Medical device evaluation

Background:

Several classification systems exist for evaluating radiographs after radial head arthroplasty (RHA).
These include systems for radiolucency (Popovic), stress shielding (Chanlalit), heterotopic ossification (Brooker), and radiocapitellar arthritis (Broberg-Morrey).
The reliability of these classification systems is not well-established.

Purpose of the Study:

To determine the interobserver and intraobserver reliability of commonly used radiographic classification systems following RHA.

Main Methods:

Six orthopedic surgeons reviewed elbow radiographs from 20 RHA patients.
Classifications assessed included Popovic (radiolucency), Chanlalit (SS), Brooker (HO), and Broberg-Morrey (radiocapitellar arthritis).
Reliability was measured using Fleiss kappa and intraclass correlation coefficients, with reviews repeated after four weeks.

Main Results:

Interobserver reliability was slight for SS and categorical radiolucency, fair for radiocapitellar arthritis and HO, and substantial for ordinal radiolucency.
Residents showed higher interobserver reliability for HO than attending surgeons.
Intraobserver reliability was fair for SS and categorical radiolucency, moderate for HO and radiocapitellar arthritis, and almost perfect for ordinal radiolucency.

Conclusions:

The number of Popovic zones for radiolucency is reliable for physician communication.
Caution is advised when using Brooker, Chanlalit, Broberg-Morrey, and categorical Popovic classifications due to variable reliability.
Intraobserver reliability consistently exceeded interobserver reliability across all classifications.