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. 2019 Apr;54(2):171-177.
doi: 10.1016/j.rbo.2017.11.003. Epub 2019 May 10.

Evaluation of the Reproducibility of the Dejour Classification for Femoropatellar Instability

Rodrigo de Souza Mendes Santiago Mousinho  1 , José Neias Araújo Ribeiro  2 , Francisco Kartney Sarmento Pedrosa  1 , Diego Ariel de Lima  1   2   3   4 , Romeu Krause Gonçalves  1 , José Alberto Dias Leite  2   3
Affiliations

Evaluation of the Reproducibility of the Dejour Classification for Femoropatellar Instability

Rodrigo de Souza Mendes Santiago Mousinho et al. Rev Bras Ortop (Sao Paulo). 2019 Apr.

Abstract

Objective To evaluate the classification proposed by David Dejour to describe trochlear dysplasia of the knee through inter- and intraobserver reproducibility measurements. Methods Ten patients with trochlear dysplasia were studied. Three physicians, members of the Sociedade Brasileira de Cirurgia do Joelho (Brazilian Society of Knee Surgery), were invited to evaluate the images. Intra- and interobserver analyses were performed at one-week intervals. Reproducibility was evaluated in four scenarios: using only radiography; using radiography and tomography; using radiography and consulting the classification; and using radiography and tomography, consulting the classification. Results The intraobserver evaluation presented discordant results. In the interobserver analysis, the degree of agreement was low for the analyses that used only radiography and excellent for those in which both radiography and tomography were used. Conclusion The Dejour classification presented a low intra- and interobserver reproducibility when only the profile radiography was used. It was demonstrated that the use of the radiography alone for classification may generate lack of uniformity even among experienced observers. However, when radiography and tomography were combined, reproducibility improved.

Keywords: femoropatellar joint; joint instability; reproducibility.

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Conflict of interest statement

Conflitos de interesse Os autores declaram não haver conflitos de interesse.

Figures

Fig. 1
Fig. 1
Dejour classification of trochlear dysplasia (radiography and computed tomography scan). Abbreviations: CT, computed tomography; XR, X-ray.
Fig. 2
Fig. 2
Interobserver variation at the six proposed situations. Abbreviations: CT, computed tomography; XR, X-ray.
Fig. 3
Fig. 3
Intraobserver variation ( * p  < 0.05).
Fig. 4
Fig. 4
Flow chart for patellofemoral instability treatment. Abbreviations: TT-TG; tibial tuberosity and trochlear groove; MPFL, medial patellofemoral ligament; VMO, vastus medialis obliquus.
Fig. 1
Fig. 1
Classificacão de Displasia Troclear de Dejour (radiografia e tomografia). Abreviações: Rx, raio X; TC, tomografia computadorizada.
Fig. 2
Fig. 2
Variação interobservador nas seis situações propostas.
Fig. 3
Fig. 3
Variação intraobservador (*p < 0,05).
Fig. 4
Fig. 4
Fluxograma para o tratamento da instabilidade femoropatelar.
See this image and copyright information in PMC

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