title: Interobserver and intraobserver reliability and validity of the Vancouver classification system of periprosthetic femoral fractures after hip arthroplasty.
abstract: The Vancouver classification system of periprosthetic fractures has been revalidated in this study, using the radiographs of 45 patients. Three consultants and 3 trainees reviewed the radiographs independently, on 2 separate occasions, at least 2 weeks apart. Interobserver and intraobserver agreement and validity were analyzed, using weighted κ statistics. The mean κ value for interobserver agreement was found to be 0.69 (0.63-0.72) for consultants and 0.61 (0.56-0.65) for the trainees, both representing substantial agreement. Intraobserver κ values ranged from 0.74 to 0.90, showing substantial agreement. Validity analysis of 37 type B cases revealed 81% agreement within B1, B2, and B3 subgroups with a κ value of 0.68 (substantial agreement). This study has reconfirmed the reliability and validity of the Vancouver classification while it also emphasizes the intraoperative assessment of implant stability.
authors.affiliation: Department of Trauma and Orthopaedics, Our Lady of Lourdes Hospital, Drogheda, Co., Louth, Republic of Ireland.
authors.forename: Gohar A
authors.initials: GA
authors.lastname: Naqvi
authors.forename: Shakoor A
authors.initials: SA
authors.lastname: Baig
authors.forename: Nasir
authors.initials: N
authors.lastname: Awan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000295:instrumentation; D002965:Classification / Q000379:methods*; D005260:Female; D005264:Femoral Fractures / Q000145:classification* / Q000000981:diagnostic imaging / Q000209:etiology*; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D006621:Hip Joint / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D057068:Periprosthetic Fractures / Q000145:classification* / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D015203:Reproducibility of Results