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Assessment of inter- and intra-observer reliability in the determination of radiographic version and inclination of the cup in metal-on-metal hip resurfacing

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Abstract

Purpose

Determination of the cup orientation after metal-on-metal hip resurfacing may provide important information in the postoperative follow-up. We present a mathematical method based on a previously described approach to assess the version and inclination of the cup in the metal-on-metal bearing without a separate software computation from plain radiographs. The aim of the study was to assess the intra- and inter-observer reliability of this method.

Methods

Calculation of version and inclination were done twice for 20 hip resurfacings by four observers. Intra-observer reliability was estimated by mean error and correlation of the two sets of measurement for version and inclination. Bland-Altman plots, intra-class coefficient and mean error were used to assess the inter-observer reliability of the measurements.

Results

Intra-observer correlation for version measurement ranged from 0.74 to 0.94. Correlation for inclination varied between 0.94 and 0.97. Upper and lower limits of agreement in Bland-Altman plots for version measurements between observers ranged from 4.1 to 7.2 degrees and from −3.2 to −8.3 degrees, respectively. For inclination measurements the upper and lower limits ranged from 3.1 to 5.3 degrees and from −2.7 to −6.0 degrees.

Conclusions

Mean errors, correlation coefficients and 95% limits of agreement were on an acceptable level. We believe that this method is applicable for clinical use.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Coxa Ltd, Hospital for Joint Replacement, Tampere, Finland

    Aleksi Reito, Timo Puolakka & Jorma Pajamäki

  2. Medical Imaging Centre, Tampere University Hospital, Tampere, Finland

    Antti Paakkala

Authors
  1. Aleksi Reito
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  2. Timo Puolakka
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  3. Antti Paakkala
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  4. Jorma Pajamäki
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Correspondence to Jorma Pajamäki.

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Reito, A., Puolakka, T., Paakkala, A. et al. Assessment of inter- and intra-observer reliability in the determination of radiographic version and inclination of the cup in metal-on-metal hip resurfacing. International Orthopaedics (SICOT) 36, 519–525 (2012). https://doi.org/10.1007/s00264-011-1328-1

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  • DOI: https://doi.org/10.1007/s00264-011-1328-1

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