Inter and intra-observer agreement of the 3-dimensional CT based anterior inferior iliac spine classification system shows fair-to-moderate agreement among high volume hip surgeons.
3D Reconstruction
AIIS morphology
Hetsroni classification
Subspine impingement
Journal
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN: 1433-7347
Titre abrégé: Knee Surg Sports Traumatol Arthrosc
Pays: Germany
ID NLM: 9314730
Informations de publication
Date de publication:
Jan 2023
Jan 2023
Historique:
received:
15
11
2021
accepted:
04
05
2022
pubmed:
2
6
2022
medline:
25
1
2023
entrez:
1
6
2022
Statut:
ppublish
Résumé
The purpose of this multicenter, multinational study is to evaluate the agreement level of the Hetsroni's classification system across high-volume hip surgeons who specialize in hip preservation surgeries. Four surgeons from three countries reviewed a digital survey that included 93 3D CT images of the hip from 53 patients. The population was composed of individuals who had undergone a pelvis CT scan in a tertiary hospital between 2000 and 2016. Each rater reviewed the images and classified each image according to AIIS subtype I, II, or III. After a minimum of two months, the raters repeated the survey. The inter-rater and intra-rater agreement was then assessed. The kappa values were calculated to determine variability. Inter-rater agreement levels yielded fair agreement for both sessions (Kappa = 0.4, p value < 0.001 in the first and Kappa = 0.27, p value < 0.001 in the second). Inter-rater agreement levels separating non-pathological Type I from pathological Types II and III yielded moderate to fair inter-rater agreement levels (K = 0.47, p value < 0.001 in the first session and k = 0.32, p value < 0.001 in the second). Intra-rater reliability displayed moderate agreement (average K = 0.53). The current 3D CT-based AIIS classification system shows fair-to-moderate inter- and intra-rater agreement among high-volume hip surgeons. According to this study, the agreement of the Hetsroni classification system is not able to be sufficiently reproduced. Since accurate classification of the AIIS morphology is imperative in establishing proper treatment for SSI, this classification system there is therefore limited in its clinical value. III.
Identifiants
pubmed: 35648177
doi: 10.1007/s00167-022-06999-0
pii: 10.1007/s00167-022-06999-0
doi:
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
50-57Informations de copyright
© 2022. The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).
Références
Aguilera-Bohorquez B, Brugiatti M, Coaquira R, Cantor E (2019) Frequency of subspine impingement in patients with femoroacetabular impingement evaluated with a 3-dimensional dynamic study. Arthroscopy 35:91–96
doi: 10.1016/j.arthro.2018.08.035
Amar E, Rosenthal R, Guanche CA, Palmanovich E, Ankory R, Levy O et al (2021) Sonographic evaluation of anterior inferior iliac spine morphology demonstrates excellent accuracy when compared to false profile view. Knee Surg Sports Traumatol Arthrosc 29:1413–1419
doi: 10.1007/s00167-020-06304-x
Amar E, Warschawski Y, Sharfman ZT, Martin HD, Safran MR, Rath E (2016) Pathological findings in patients with low anterior inferior iliac spine impingement. Surg Radiol Anat 38:569–575
doi: 10.1007/s00276-015-1591-8
Audige L, Bhandari M, Hanson B, Kellam J (2005) A concept for the validation of fracture classifications. J Orthop Trauma 19:401–406
Balazs GC, Williams BC, Knaus CM, Brooks DI, Dickens JF, McCabe MP et al (2017) Morphological distribution of the anterior inferior iliac spine in patients with and without hip impingement: reliability, validity, and relationship to the intraoperative assessment. Am J Sports Med 45:1117–1123
doi: 10.1177/0363546516682230
Bech NH, Haverkamp D (2018) Impingement around the hip: beyond cam and pincer. EFORT Open Rev 3:30–38
doi: 10.1302/2058-5241.3.160068
Carton P, Filan D (2016) Anterior inferior iliac spine (AIIS) and subspine hip impingement. Muscles Ligaments Tendons J 6:324–336
doi: 10.32098/mltj.03.2016.08
Chen AW, Steffes MJ, Laseter JR, Maldonado DR, Ortiz-Declet V, Perets I et al (2020) How has arthroscopic management of the iliopsoas evolved, and why? A survey of high-volume arthroscopic hip surgeons. J Hip Preserv Surg 7:322–328
doi: 10.1093/jhps/hnaa023
Curley AJ, Owens JS, Jimenez AE, Maldonado DR, Saks BR, Sabetian PW et al (2022) Arthroscopic subspine decompression is commonly reported in a heterogenous patient population with concomitant procedures: a systematic review. Arthroscopy. https://doi.org/10.1016/j.arthro.2022.01.049
doi: 10.1016/j.arthro.2022.01.049
Fleiss JL (1971) Measuring nominal scale agreement among many raters. Psychol Bull 76:378–382
doi: 10.1037/h0031619
Hetsroni I, Poultsides L, Bedi A, Larson CM, Kelly BT (2013) Anterior inferior iliac spine morphology correlates with hip range of motion: a classification system and dynamic model. Clin Orthop Relat Res 471:2497–2503
doi: 10.1007/s11999-013-2847-4
Hong H, Choi Y, Hahn S, Park SK, Park BJ (2014) Nomogram for sample size calculation on a straightforward basis for the kappa statistic. Ann Epidemiol 24:673–680
doi: 10.1016/j.annepidem.2014.06.097
Karns MR, Adeyemi TF, Stephens AR, Aoki SK, Beese ME, Salata MJ et al (2018) Revisiting the anteroinferior iliac spine: is the subspine pathologic? A clinical and radiographic evaluation. Clin Orthop Relat Res 476:1494–1502
doi: 10.1097/01.blo.0000533626.25502.e1
Krueger DR, Windler M, Gesslein M, Schuetz M, Perka C, Schroeder JH (2017) Is the evaluation of the anterior inferior iliac spine (AIIS) in the AP pelvis possible? Analysis of conventional X-rays and 3D-CT reconstructions. Arch Orthop Trauma Surg 137:975–980
doi: 10.1007/s00402-017-2694-y
Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174
doi: 10.2307/2529310
Larson CM, Giveans MR, Samuelson KM, Stone RM, Bedi A (2014) Arthroscopic hip revision surgery for residual femoroacetabular impingement (FAI): surgical outcomes compared with a matched cohort after primary arthroscopic FAI correction. Am J Sports Med 42:1785–1790
doi: 10.1177/0363546514534181
Larson CM, Kelly BT, Stone RM (2011) Making a case for anterior inferior iliac spine/subspine hip impingement: three representative case reports and proposed concept. Arthroscopy 27:1732–1737
doi: 10.1016/j.arthro.2011.10.004
Michal F, Amar E, Atzmon R, Sharfman Z, Haviv B, Eisenberg G et al (2020) Subspinal impingement: clinical outcomes of arthroscopic decompression with one year minimum follow up. Knee Surg Sports Traumatol Arthrosc 28:2756–2762
doi: 10.1007/s00167-018-4923-5
Pan H, Kawanabe K, Akiyama H, Goto K, Onishi E, Nakamura T (2008) Operative treatment of hip impingement caused by hypertrophy of the anterior inferior iliac spine. J Bone Joint Surg Br 90:677–679
doi: 10.1302/0301-620X.90B5.20005
Perets I, Rybalko D, Mu BH, Friedman A, Morgenstern DR, Domb BG (2019) Hip arthroscopy: extra-articular procedures. Hip Int 29:346–354
doi: 10.1177/1120700019840729
Schaver AL, Leary SM, Henrichsen JL, Larson CM, Westermann RW (2022) Outcomes of arthroscopic decompression of the anterior inferior iliac spine: a systematic review and meta-analysis. Am J Sports Med. https://doi.org/10.1177/036354652110629033635465211062903
doi: 10.1177/036354652110629033635465211062903
Tateishi S, Onishi Y, Suzuki H, Takahashi M, Shiraishi J, Larson CM et al (2020) Arthroscopic anterior inferior iliac spine decompression does not alter postoperative muscle strength. Knee Surg Sports Traumatol Arthrosc 28:2763–2771
doi: 10.1007/s00167-018-5026-z