Reliability of the Oswestry-Bristol Classification for trochlear dysplasia: expanded characteristics

Bone Jt Open. 2020 Nov 2;1(7):355-358. doi: 10.1302/2633-1462.17.BJO-2020-0048.R1. eCollection 2020 Jul.

Abstract

Aims: The Oswestry-Bristol Classification (OBC) was recently described as an MRI-based classification tool for the femoral trochlear. The authors demonstrated better inter- and intraobserver agreement compared to the Dejour classification. As the OBC could potentially provide a very useful MRI-based grading system for trochlear dysplasia, it was the aim to determine the inter- and intraobserver reliability of the classification system from the perspective of the non-founder.

Methods: Two orthopaedic surgeons independently assessed 50 MRI scans for trochlear dysplasia and classified each according to the OBC. Both observers repeated the assessments after six weeks. The inter- and intraobserver agreement was determined using Cohen's kappa statistic and S-statistic nominal and linear weights.

Results: The OBC with grading into four different trochlear forms showed excellent inter- and intraobserver agreement with a mean kappa of 0.78.

Conclusion: The OBC is a simple MRI-based classification system with high inter- and intraobserver reliability. It could present a useful tool for grading the severity of trochlear dysplasia in daily practice.Cite this article: Bone Joint Open 2020;1-7:355-358.

Keywords: MPFL; anterior knee pain; knee; patella dislocation; patella instability; patellofemoral joint; trochleoplasty.