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Intra- and inter-observer reliability of Laredo classification system in Legg–Calvé–Perthes Disease

  • Serkan Erkus
  • Ali Turgut
  • Onder KalendererEmail author
  • Kivanc Yuksel
Original Article • HIP - PAEDIATRIC
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Abstract

The purpose of the current study was to investigate intra- and inter-observer reliability of arthrographic Laredo classification system in Perthes disease. Forty-seven patients were included in this cross-sectional descriptive study. Patients’ age, gender, physical findings and hip arthrographs were collected from hospital medical records. Two different sets of power point slides were prepared in which the order of cases was randomized and blinded. Observers were divided into three groups according to their surgical experience (9 residents, 10 seniors, 10 pediatric orthopedists), and they assessed two times 1 month’s intervals. Statistical analysis was performed by using the SPSS v21. Inter- and intra-observer reliabilities were calculated using intra-class correlation coefficient, weighted kappa and percentage agreement. Percentage agreement of Laredo classification was about 50% for all groups (residents, seniors and pediatric orthopedists); intra-observer reliabilities were excellent, excellent and fair, respectively. Inter-observer reliability of Laredo classification for each set was found to be excellent for all groups. Length of experience did not correlated significantly with the level of intra-observer agreement. As a conclusion, our results showed that Laredo’s arthrographic classification system’s intra-observer reliability is at least at a fair level and inter-observer reliability is at an excellent level. We believe that this classification system is valuable for an orthopedic surgeon who deals with the treatment of Perthes disease.

Keywords

Arthrography Reliability Laredo classification Perthes Children 

Notes

Acknowledgements

We thank Asuman Filiz Guzelant for her contribution.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Rampal V, Clément JL, Solla F (2017) Legg–Calvé–Perthes disease: classifications and prognostic factors. Clin Cases Miner Bone Metab 14(1):74–82CrossRefGoogle Scholar
  2. 2.
    Herring JA, Kim HT, Browne R (2004) Legg–Calvé–Perthes disease: part I: classification of radiographs with use of the modified lateral pillar and Stulberg classifications. J Bone Joint Surg 86-A:2103–2120CrossRefGoogle Scholar
  3. 3.
    Mose K (1980) Methods of measuring in Legg–Calvé–Perthes disease with special regard to the prognosis. Clin Orthop Relat Res 150:103–109Google Scholar
  4. 4.
    Grasemann H, Nicolai RD, Patsalis T, Hovel M (1997) The treatment of Legg–Calvé–Perthes disease. To contain or not to contain. Arch Orthop Trauma Surg 116:50–54CrossRefGoogle Scholar
  5. 5.
    Herring JA (1994) The treatment of Legg–Calvé–Perthes disease. Current concepts review. J Bone Joint Surg Am 76:448–458CrossRefGoogle Scholar
  6. 6.
    Chaudhry S, Phillips D, Feldman D (2014) Legg–Calvé–Perthes Disease: an overview with recent literature. Bull Hosp Jt Dis 72(1):18–27Google Scholar
  7. 7.
    de Sanctis N, Rondinella F (2000) Prognostic evaluation of Legg–Calvé–Perthes disease by MRI. Part II: pathomorphogenesis and new classification. J Pediatr Orthop 20(4):463–470Google Scholar
  8. 8.
    Jaramillo D, Galen TA, Winalski CS (1999) Legg–Calvé–Perthes disease: MR imaging evaluation during manual positioning of the hip: comparison with conventional arthrography. Radiology 12:519–525CrossRefGoogle Scholar
  9. 9.
    Dimeglio A, Canavese F (2011) Imaging in Legg–Calvé–Perthes disease. Orthop Clin N Am 42:297–302CrossRefGoogle Scholar
  10. 10.
    Catterall A (1971) The natural history of Perthes’ disease. J Bone Joint Surg 53-B:37–53CrossRefGoogle Scholar
  11. 11.
    Salter RB, Thompson GH (1984) Legg–Calvé–Perthes disease. The prognostic significance of the subchondral fracture and a two-group classification of the femoral head involvement. J Bone Joint Surg Am 66:479–489CrossRefGoogle Scholar
  12. 12.
    Stulberg SD, Cooperman DR, Wallensten R (1981) The natural history of Legg–Calve–Perthes disease. J Bone Joint Surg 63-A:1095–1108CrossRefGoogle Scholar
  13. 13.
    Herring JA, Neustadt JB, Williams JJ, Early JS, Browne RH (1992) The lateral pillar classification of Legg–Calvé–Perthes disease. J Pediatr Orthop 12:143–150CrossRefGoogle Scholar
  14. 14.
    Laredo FJ (1992) Legg–Calvé–Perthes disease: arthrographic classification. Rev Bras Orthop 27:7–10Google Scholar
  15. 15.
    Kalenderer O, Agus H, Ozcalabi IT, Ozluk S (2005) The importance of surgeons’ experience on intraobserver and interobserver reliability of classifications used for Perthes disease. J Pediatr Orthop 25:460–464CrossRefGoogle Scholar
  16. 16.
    Agus H, Kalenderer O, Eryanılmaz G, Ozcalabi IT (2004) Intraobserver and interobserver reliability of Catterall, Herring, Salter–Thompson and Stulberg classification systems in Perthes disease. J Pediatr Orthop 13:166–169Google Scholar
  17. 17.
    Wiig O, Terjesen T, Svenningsen S (2002) Interobserver reliability of radiographic classifications and measurements in the assessment of Perthes disease. Acta Orthop Scand 73:523–530CrossRefGoogle Scholar
  18. 18.
    Sambandan NS, Gul A, Shankar R, Goni V (2006) Reliability of radiological classifications used in Legg–Calvé–Perthes disease. J Pediatr Orthop 15:267–270CrossRefGoogle Scholar
  19. 19.
    Mahadeva D, Chong M, Langton DJ, Turner AM (2010) Reliability and reproducibility of classification systems for Legg–Calvé–Perthes disease: a systematic review of the literature. Acta Orthop Belg 76:48–57Google Scholar
  20. 20.
    Simmons ED, Graham HK, Szalai JP (1990) Interobserver variability in grading Perthes disease. J Bone Joint Surg 72-B:202–204CrossRefGoogle Scholar
  21. 21.
    Ritterbusch JF, Shantaram SS, Gelinas C (1993) Comparison of lateral pillar classification and Catterall classification of Legg–Calvé–Perthes disease. J Pediatr Orthop 13:200–202Google Scholar
  22. 22.
    Fleiss JL (1986) Reliability of measurement. In: Fleiss JL (ed) The design and analysis of clinical experiments. Wiley, New York, pp 1–32Google Scholar
  23. 23.
    Rae G (1988) The equivalence of multiple rater kappa statistics and intraclass correlation coefficients. Educ Psychol Meas 48:367–374CrossRefGoogle Scholar
  24. 24.
    Fleiss JL, Cohen J (1973) The equivalence of weighted kappa and intraclass correlation coefficient as measures of reliability. Educ Psychol Meas 33:613–619CrossRefGoogle Scholar
  25. 25.
    Altman DB (1999) Practical Statistics for Medical Research. Chapman & Hall, LondonGoogle Scholar
  26. 26.
    Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefGoogle Scholar
  27. 27.
    Karanicolas PJ, Bhandari M, Kreder H, Moroni A, Richardson M, Walter SD, Norman GR, Guyatt GH, Collaboration for Outcome Assessment in Surgical Trials (COAST) Musculoskeletal Group (2009) Evaluating agreement: conducting a reliability study. J Bone Joint Surg Am 91(Suppl 3):99–106CrossRefGoogle Scholar
  28. 28.
    Milani C, Dobashi ET (2011) Arthrogram in Legg–Calvé–Perthes disease. J Pediatr Orthop 31(Suppl 2):56–62Google Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  • Serkan Erkus
    • 1
  • Ali Turgut
    • 1
  • Onder Kalenderer
    • 1
    Email author
  • Kivanc Yuksel
    • 2
  1. 1.Department of Orthopaedics and TraumatologyTepecik Training and Research HospitalİzmirTurkey
  2. 2.Ege University School of Medicine ARGEFARİzmirTurkey

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