The cerebral palsy hip classification is reliable: an inter- and intra-observer reliability study

J Bone Joint Surg Br. 2010 Mar;92(3):436-41. doi: 10.1302/0301-620X.92B3.23105.

Abstract

We have tested the reliability of a recently reported classification system of hip morphology in adolescents with cerebral palsy in whom the triradiate cartilage was closed. The classification is a six-grade ordinal scale, based on the measurement of the migration percentage and an assessment of Shenton's arch, deformity of the femoral head, acetabular deformity and pelvic obliquity. Four paediatric orthopaedic surgeons and four physiotherapists received training in the use of the classification which they applied to the assessment of 42 hip radiographs, read on two separate occasions. The inter- and intra-observer reliability was assessed using the intraclass correlation coefficient and found to be excellent, with it ranging from 0.88 to 0.94. The classification in our study was shown to be valid (based on migration percentage), and reliable. As a result we believe that it can now be used in studies describing the natural history of hip displacement in cerebral palsy, in outcome studies and in communication between clinicians.

Publication types

  • Validation Study

MeSH terms

  • Adolescent
  • Cerebral Palsy / classification*
  • Cerebral Palsy / diagnostic imaging
  • Cerebral Palsy / surgery
  • Female
  • Hip Dislocation, Congenital / classification*
  • Hip Dislocation, Congenital / diagnostic imaging
  • Hip Dislocation, Congenital / surgery
  • Hip Joint / diagnostic imaging
  • Hip Joint / surgery
  • Humans
  • Male
  • Observer Variation
  • Radiography
  • Reproducibility of Results
  • Salvage Therapy
  • Severity of Illness Index