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Related Experiment Video

Updated: Sep 23, 2025

The Use of Mixed Reality in Custom-Made Revision Hip Arthroplasty: A First Case Report

The Use of Mixed Reality in Custom-Made Revision Hip Arthroplasty: A First Case Report

Published on: August 4, 2022

Development of the Revision Hip Complexity Classification using a modified Delphi technique.

Justin W Y Leong¹, Rohit Singhal², Michael R Whitehouse^3,4

¹Department of Trauma and Orthopaedic Surgery, Countess of Chester Hospital NHS Foundation Trust, Chester, UK.

Bone & Joint Open

|May 13, 2022

Summary

This summary is machine-generated.

A new Revision Hip Complexity Classification (RHCC) was developed to standardize discussions of complex hip revision cases. This tool enhances multidisciplinary team communication and patient management by providing a reproducible method for assessing surgical complexity.

Keywords:

Anesthesiologists Bone loss Delphi methodology Delphi process Dislocation Hip Infection Periprosthetic fracture Revision Hip Complexity Classification Revision total hip arthroplasty acetabulum bone loss debridement, antibiotics, and implant retention femur medical comorbidities periprosthetic fractures revision hip surgery

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Area of Science:

Orthopedic Surgery
Surgical Complexity Classification
Hip Revision Arthroplasty

Background:

Complex hip revision cases require standardized assessment for effective multidisciplinary team (MDT) discussions.
Existing classification systems may not fully capture the nuances of surgical complexity and patient comorbidities in hip revisions.

Purpose of the Study:

To develop a structured Revision Hip Complexity Classification (RHCC) using a modified Delphi process.
To create a tool to aid MDT discussions for complex hip revision cases within local or regional networks.

Main Methods:

A modified Delphi process involving 35 experts from the British Hip Society.
Three rounds of questionnaires and a virtual meeting were conducted to identify, weight, and group complexity factors.
Incorporated existing classification systems (Paprosky, Unified Classification System, ASA) into the RHCC framework.

Main Results:

Achieved strong consensus on 32 out of 36 identified factors.
The RHCC demonstrated good intraobserver (Kappa 0.88-0.92) and interobserver (Kappa 0.77-0.85) reliability.
Incorporated American Society of Anesthesiologists (ASA) grade III/IV patients with an asterisk qualifier.

Conclusions:

The RHCC provides a comprehensive and reproducible framework for discussing complex hip revision cases.
Adoption of the RHCC can improve the description of surgical complexity and influence patient management decisions.
Facilitates standardized communication within hip revision multidisciplinary teams.