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The Oswestry-Bristol Classification.
Sharma, Nikhil; Brown, Ashley; Bouras, Theodoros; Kuiper, Jan H; Eldridge, Jonathan; Barnett, Andrew.
Affiliation
  • Sharma N; The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, UK.
  • Brown A; The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, UK.
  • Bouras T; The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, UK.
  • Kuiper JH; The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, UK.
  • Eldridge J; Bristol Royal Infirmary, Bristol, UK.
  • Barnett A; The Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, UK.
Bone Joint J ; 102-B(1): 102-107, 2020 Jan.
Article in En | MEDLINE | ID: mdl-31888364
AIMS: Trochlear dysplasia is a significant risk factor for patellofemoral instability. The Dejour classification is currently considered the standard for classifying trochlear dysplasia, but numerous studies have reported poor reliability on both plain radiography and MRI. The severity of trochlear dysplasia is important to establish in order to guide surgical management. We have developed an MRI-specific classification system to assess the severity of trochlear dysplasia, the Oswestry-Bristol Classification (OBC). This is a four-part classification system comprising normal, mild, moderate, and severe to represent a normal, shallow, flat, and convex trochlear, respectively. The purpose of this study was to assess the inter- and intraobserver reliability of the OBC and compare it with that of the Dejour classification. METHODS: Four observers (two senior and two junior orthopaedic surgeons) independently assessed 32 CT and axial MRI scans for trochlear dysplasia and classified each according to the OBC and the Dejour classification systems. Assessments were repeated following a four-week interval. The inter- and intraobserver agreement was determined by using Fleiss' generalization of Cohen's kappa statistic and S-statistic nominal and linear weights. RESULTS: The OBC showed fair-to-good interobserver agreement and good-to-excellent intraobserver agreement (mean kappa 0.68). The Dejour classification showed poor interobserver agreement and fair-to-good intraobserver agreement (mean kappa 0.52). CONCLUSION: The OBC can be used to assess the severity of trochlear dysplasia. It can be applied in clinical practice to simplify and standardize surgical decision-making in patients with recurrent patella instability. Cite this article: Bone Joint J 2020;102-B(1):102-107.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Patellar Dislocation / Patellofemoral Joint / Joint Instability Type of study: Evaluation_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adolescent / Adult / Child / Female / Humans / Male / Middle aged Language: En Journal: Bone Joint J Year: 2020 Document type: Article Country of publication: United kingdom

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Patellar Dislocation / Patellofemoral Joint / Joint Instability Type of study: Evaluation_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adolescent / Adult / Child / Female / Humans / Male / Middle aged Language: En Journal: Bone Joint J Year: 2020 Document type: Article Country of publication: United kingdom