The Reconstructive Pelvic Anatomy classification system : a valid and reliable classification system for pelvic...

Area of Science:

• Orthopaedic Surgery
• Surgical Innovation
• Anatomical Classification Systems

Background:

• Pelvic reconstruction is complex, especially with bone loss, utilizing advanced techniques like 3D-printed prostheses.
• Optimizing patient outcomes requires careful reconstructive planning.
• A standardized classification system is needed for communication and research in pelvic reconstruction.

Purpose of the Study:

• To develop the Reconstructive Pelvic Anatomy (RPA) classification system.
• To assess the content and construct validity of the RPA system.
• To evaluate the interobserver and intraobserver agreement of the RPA classification.

Main Methods:

• The RPA classification system was developed by orthopaedic surgeons.
• Content validity was assessed by 23 surgeons using the Item-Content Validity Index (I-CVI).
• Construct validity and agreement were evaluated by applying the classification to 20 cases, with interobserver and intraobserver reliability assessed using the kappa statistic.

Main Results:

• All domains demonstrated strong content validity (I-CVI > 0.78).
• Moderate agreement was found for construct validity (kappa = 0.6).
• Interobserver agreement was moderate overall (kappa = 0.54), with substantial agreement for most domains (kappa = 0.73–0.82). Intraobserver agreement was substantial to almost perfect (kappa = 0.76–0.84).

Conclusions:

• The RPA classification system is a valid and reliable tool for pelvic reconstruction.
• The system demonstrates good content and construct validity.
• The RPA classification can enhance communication, surgical planning, and research in pelvic reconstruction.