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Application of Three-Dimensional Computed Tomography Improved the Interrater Reliability of the AO/OTA Classification Decision in a Patellar Fracture

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Abstract
We investigated whether interrater reliabilities of the AO/OTA classification of patellar fracture change with the imaging modalities applied, including plain radiography and two- and three-dimensional (2-D and 3-D) computed tomography (CT). Seven orthopedic specialists and four orthopedic residents completed a survey of 50 patellar fractures to classify the fractures according to the AO/OTA classification for patellar fractures. Initially, the survey was conducted using plain radiography only, then with 2-D CT introduced three weeks later and 3-D CT introduced six weeks later. Fleiss' Kappa coefficients were calculated to determine interrater reliability. The overall interrater reliability of the AO/OTA classifications was 0.40 (95% CI, 0.38-0.42) with plain radiography only and 0.43 (95% CI, 0.41-0.45) with the addition of 2-D CT. With the addition of 3-D CT, the reliability was significantly improved to 0.54 (95% CI, 0.52-0.56). In specialists, interrater reliability of the classifications was moderate with all three imaging modalities. With the use of 3-D CT, interrater reliability of the classification was 0.53 (95% CI, 0.50-0.56), which was significantly higher than that with the use of 2-D CT (kappa = 0.45; 95% CI, 0.42-0.48). In residents, interrater reliability of the classification was 0.30 (95% CI, 0.24-0.36) with plain radiography. The reliability improved to 0.49 (95% CI, 0.43-0.56) with the addition of 2-D CT, which was significantly higher than that with plain radiography only. The use of 3-D CT imaging improved interrater reliability of the classification. Therefore, surgeons, especially residents, may benefit from using 3-D CT imaging for classifying and planning the treatment of patellar fractures.
Author(s)
변성은손욱진심재앙주용범김지완나영곤최원철
Issued Date
2021
Type
Article
Keyword
3-D CTAO/OTA classificationClassificationinterrater reliabilityKneeOrthopedicspatellapatellar fractureRadiographythree-dimensional computed tomographyTomographyTrauma
DOI
10.3390/jcm10153256
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8669
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_db0f2d6b8a5a4cbb8194d45290c6e7a9&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Application%20of%20Three-Dimensional%20Computed%20Tomography%20Improved%20the%20Interrater%20Reliability%20of%20the%20AO%2FOTA%20Classification%20Decision%20in%20a%20Patellar%20Fracture&offset=0&pcAvailability=true
Publisher
JOURNAL OF CLINICAL MEDICINE
Location
스위스
Language
한국어
ISSN
2077-0383
Citation Volume
10
Citation Number
15
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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