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Dillard S, Schilero C, Chiang S, et al. Intra- and Interobserver Reliability of Three Classification Systems for Hallux Rigidus. J Am Podiatr Med Assoc. 2018;doi: 10.7547/16-126.
Dillard, S., Schilero, C., Chiang, S., & Pham, P. (2018). Intra- and Interobserver Reliability of Three Classification Systems for Hallux Rigidus. Journal of the American Podiatric Medical Association, . https://doi.org/10.7547/16-126
Dillard, Sarita, et al. "Intra- and Interobserver Reliability of Three Classification Systems for Hallux Rigidus." Journal of the American Podiatric Medical Association vol. (2018). doi: https://doi.org/10.7547/16-126
Dillard S, Schilero C, Chiang S, Pham P. Intra- and Interobserver Reliability of Three Classification Systems for Hallux Rigidus. J Am Podiatr Med Assoc. 2018 Apr 18; doi: 10.7547/16-126. Epub 2018 Apr 18. PMID: 29668298; PMCID: PMC6677635.
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J Am Podiatr Med Assoc. 2018 Apr 18; doi: 10.7547/16-126. Epub 2018 Apr 18.

Intra- and Interobserver Reliability of Three Classification Systems for Hallux Rigidus.

Journal of the American Podiatric Medical Association

Sarita Dillard, Christina Schilero, Sharon Chiang, Peter Pham

Affiliations

  1. * West Houston Medical Center Podiatry.
  2. † West Houston Medical Center Podiatry.
  3. ‡ Baylor College of Medicine.
  4. § West Houston Medical Center.

PMID: 29668298 PMCID: PMC6677635 DOI: 10.7547/16-126

Abstract

BACKGROUND: There are over ten classification systems currently used in the staging of hallux rigidus. This results in confusion and inconsistency with radiographic interpretation and treatment. The reliability of hallux rigidus classification systems has not yet been tested. The purpose of this study was to evaluate intra- and interobserver reliability using three commonly used classifications for hallux rigidus.

METHODS: Twenty-one plain radiograph sets were presented to ten ACFAS board-certified foot and ankle surgeons. Each physician classified each radiograph based on clinical experience and knowledge according to the Regnauld, Roukis, and Hattrup and Johnson classification systems. The two-way mixed single-measure consistency intraclass correlation was used to calculate intra- and interrater reliability.

RESULTS: The intrarater reliability of individual sets for the Roukis and Hattrup and Johnson classification systems was "fair to good" (Roukis, 0.62±0.19; Hattrup and Johnson, 0.62±0.28), whereas the intrarater reliability of individual sets for the Regnauld system bordered between "fair to good" and "poor" (0.43±0.24). The interrater reliability of the mean classification was "excellent" for all three classification systems. Conclusions Reliable and reproducible classification systems are essential for treatment and prognostic implications in hallux rigidus. In our study, Roukis classification system had the best intrarater reliability. Although there are various classification systems for hallux rigidus, our results indicate that all three of these classification systems show reliability and reproducibility.

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