Comparative characteristics of radiographic classifications of the consequences of septic coxitis in children

Introduction Septic coxitis is sustained in the early childhood and has a devastating effect on the musculoskeletal system. Systematization of the acquired defects and deformities is of great importance for treatment planning and outcome prediction. A radiographic classification based on the features of the deformities in the proximal femur and acetabulum as well as on their mutual orientation was proposed at the Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics. Purpose To study the reliability of the mentioned classification and to compare it with other classifications. Material and Methods Six orthopedic surgeons divided into two groups according to their specialization evaluated 23 X-rays of the hips using the classification systems of I.H. Choi, O.A. Sokolovsky, Е. Forlin, and RISC for RTO. Two orthopedic surgeons re-evaluated them two weeks later. Intra-rater and inter-rater agreement was determined using kappa value calculations. Results The number of inter-rater and intra-rater consensus depended on the specialization of experts, and it was higher in the first group. The highest proportion of the coincidences of three expert conclusions was observed when the classification systems of Forlin and RISC for RTO were used. The values of intra-rater and inter-rater reliability of the RISC for RTO classification were 0.542-0.641 and 0.436-0.738. Conclusion Taking into account a sufficient level of reliability, the RISC RTO classification can be used as a working system by planning surgical treatment and for prediction of its outcome in children with consequences of septic coxitis.