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Interobserver reliability of the radiographic assessment of cement fixation in total hip arthroplasty

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

The objective of this work is to evaluate the performance of a modified quantitative Barrack Cement grading in primary THA. Previous studies demonstrated both poor intraobserver and interobserver reliability which may be due to the qualitative nature of the scale.

Methods

Interobserver reliability of the Barrack Cement Grading System in its original format and then in combination with a quantitative measurement of implant/cement lengths was evaluated on 50 immediate post-operative radiographs of primary cemented arthroplasties. Intraobserver reliability was also assessed on a sub-sample of radiographs. Three evaluators with different skill levels and specialty participated: an arthroplasty surgeon, an orthopaedic resident and a radiologist. Reliability was measured using a weighted kappa coefficient for paired comparisons among the evaluators.

Results

Interobserver reliability was poor (κ < 0.10) for all pairings of the Barrack System. The modified quantitative system achieved slight (κ < 0.20) to poor reliability. Intraobserver reliability was dependent on the skill and specialty of the evaluator with maximal values achieved for the experienced arthroplasty surgeon using the modified quantitative system (κ = 0.62).

Conclusion

Use of the modified scale may improve the reliability of ratings when used by individual experienced arthroplasty surgeons.

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Conflict of interest

The authors have no conflict of interest to declare nor have they received any funding in the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Orthopaedics, College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Saudi Arabia

    Abdulaziz Al-Ahaideb & Khalid A. Alsaleh

  2. Department of Medicine, Division of Geriatric Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada

    S. W. Muir

  3. Department of Surgery, Division of Orthopaedic Surgery, University of Alberta, Edmonton, AB, Canada

    J. Huckell

  4. Department of Diagnostic Imaging, Alberta Health Services—Edmonton Zone, Edmonton, AB, Canada

    M. A. Johnson

  5. Department of Surgery, Division of Orthopaedic Surgery, Alberta Health Services—Edmonton Zone, Edmonton, AB, Canada

    D. W. C. Johnston

  6. Division of Orthopaedic Surgery, Departments of Surgery and Physical Therapy, University of Alberta, Edmonton, AB, Canada

    L. A. Beaupre

Authors
  1. Abdulaziz Al-Ahaideb
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  2. S. W. Muir
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  3. J. Huckell
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  4. Khalid A. Alsaleh
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  5. M. A. Johnson
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  6. D. W. C. Johnston
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  7. L. A. Beaupre
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Corresponding author

Correspondence to Abdulaziz Al-Ahaideb.

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Al-Ahaideb, A., Muir, S.W., Huckell, J. et al. Interobserver reliability of the radiographic assessment of cement fixation in total hip arthroplasty. Eur J Orthop Surg Traumatol 23, 889–894 (2013). https://doi.org/10.1007/s00590-012-1108-7

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  • DOI: https://doi.org/10.1007/s00590-012-1108-7

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