Periprosthetic humerus fractures after shoulder arthroplasty: an evaluation of available classification systems

Kuhn, M Zino; King, Joseph J.; Wright, Thomas W.; Farmer, Kevin W.; Levy, Jonathan C.; Hao, Kevin A.; Wallace, Austin; Patrick, Matthew

doi:10.1016/j.jse.2022.04.011

Cited by 2 publications

(10 citation statements)

References 26 publications

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“…24 Their kappa coefficient findings for intraobserver and interobserver reliabilities for the Wright and Cofield system were higher than our findings (0.44 and 0.04, respectively). However, this may suggest that the UCS has a higher intraobserver and interobserver reliability than the other systems Kuhn et al 24 evaluated because we found it to be superior to the Wright and Cofield system.…”

Section: Discussioncontrasting

confidence: 89%

“…They found the Wright and Cofield system to have both the highest intraobserver (kappa 0.703) and interobserver (kappa 0.583) agreement of the 4 systems they evaluated, reporting a statistically significantly greater kappa coefficient for interobserver reliability. 24 Their kappa coefficient findings for intraobserver and interobserver reliabilities for the Wright and Cofield system were higher than our findings (0.44 and 0.04, respectively). However, this may suggest that the UCS has a higher intraobserver and interobserver reliability than the other systems Kuhn et al 24 evaluated because we found it to be superior to the Wright and Cofield system.…”

Section: Discussioncontrasting

confidence: 89%

“…Recently, Kuhn et al 24 published a study evaluating intraobserver and interobserver reliabilities of the Wright and Cofield, Campbell, Worland, and Groh systems using a collection of injury radiographs from 34 periprosthetic humerus fractures. They found the Wright and Cofield system to have both the highest intraobserver (kappa 0.703) and interobserver (kappa 0.583) agreement of the 4 systems they evaluated, reporting a statistically significantly greater kappa coefficient for interobserver reliability.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Reliability of Current Classification Systems for Periprosthetic Fractures of the Humerus

Auran

Tran

Dehghan

et al. 2023

Journal of Orthopaedic Trauma

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Section: Discussioncontrasting

confidence: 89%

Section: Discussioncontrasting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Reliability of Current Classification Systems for Periprosthetic Fractures of the Humerus

Auran

Tran

Dehghan

et al. 2023

Journal of Orthopaedic Trauma

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“…The literature regarding intra-rater and inter-rater reliability for PPSFx shoulder classifications is still scarce. Previous studies evaluated the reliability of classification systems for humeral-sided PPSFx [17][18][19][20]. Kuhn et al and Auran demanded a more reliable and clinically relevant classification system [17,18].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies evaluated the reliability of classification systems for humeral-sided PPSFx [17][18][19][20]. Kuhn et al and Auran demanded a more reliable and clinically relevant classification system [17,18].…”

Section: Introductionmentioning

confidence: 99%

Inter-Observer and Intra-Observer Reliability Assessment of the Established Classification Systems for Periprosthetic Shoulder Fractures

Wiethölter

Akgün

Plachel

et al. 2023

JCM

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This study evaluated the reliability and comprehensiveness of the Unified classification system (UCPF), Wright & Cofield, Worland and Kirchhoff classifications and related treatment recommendations for periprosthetic shoulder fractures (PPSFx). Two shoulder arthroplasty specialists (experts) and two orthopaedic residents (non-experts) assessed 20 humeral-sided and five scapula-sided cases of PPSFx. We used the unweighted Cohen’s Kappa (κ) for measuring the intra-observer reliability and Krippendorff’s alpha (α) for measuring the inter-observer reliability. The inter-rater reliabilities for the Wright & Cofield and Worland classifications were substantial for all groups. The expert and non-expert groups for UCPF also showed substantial inter-rater agreement. The all-rater group for the UCPF and the expert and non-expert group for the Kirchhoff classification revealed moderate inter-rater reliability. For the Kirchhoff classification, only fair inter-rater reliability was found for the non-expert group. Almost perfect intra-rater reliability was measured for all groups of the Wright & Cofield classification and the all-rater and expert groups of the UCPF. All groups of the Kirchhoff and Worland classifications and the group of non-experts for the UCPF had substantial intra-rater reliabilities. Regarding treatment recommendations, substantial inter-rater and moderate intra-rater reliabilities were found. Simple classification systems for PPSFx (Wright & Cofield, Worland) show the highest inter- and intra-observer reliability but lack comprehensiveness as they fail to describe scapula-sided fractures. The complex Kirchhoff classification shows limited reliability. The UCPF seems to offer an acceptable combination of comprehensiveness and reliability.

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Periprosthetic humerus fractures after shoulder arthroplasty: an evaluation of available classification systems

Cited by 2 publications

References 26 publications

Reliability of Current Classification Systems for Periprosthetic Fractures of the Humerus

Reliability of Current Classification Systems for Periprosthetic Fractures of the Humerus

Inter-Observer and Intra-Observer Reliability Assessment of the Established Classification Systems for Periprosthetic Shoulder Fractures

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