Abstract
Intra- and Interobserver Reliability of the New Classification System of Progressive Collapsing Foot Deformity
Foot & ankle international, Vol.43(4), pp.582-589
04/01/2022
DOI: 10.1177/10711007211058154
PMID: 35097796
Abstract
Background: Historical concept of flatfoot as posterior tibial tendon dysfunction (PTTD) has been questioned. Recently, the consensus group published a new classification system and recommended renaming PTTD to Progressive Collapsing Foot Deformity (PCFD). The new PCFD classification could be effective in providing comprehensive information on the deformity. To date, there has been no study reporting intra- and interobserver reliability and the frequency of each class in PCFD classification. Methods: This was a single-center, retrospective study conducted from prospectively collected registry data. A consecutive cohort of PCFD patients evaluated from February 2015 to October 2020 was included, consisting of 92 feet in 84 patients. Classification of each patient was made using characteristic clinical and radiographic findings by 3 independent observers. Frequencies of each class and subclass were assessed. Intraobserver and inteobserver reliabilities were analyzed with Cohen kappa and Fleiss kappa, respectively. Results: Mean sample age was 54.4, 38% was male and 62% were female. 1ABC (25.4%) was the most common subclass, followed by 1AC (8.7%) and 1ABCD (6.9%). Only a small percentage of patients had isolated deformity. Class A was the most frequent component (89.5%), followed by C in 86.2% of the cases. Moderate interobserver reliability (Fleiss kappa = 0.561, P < .001, 95% CI 0.528-0.594) was found for overall classification. Very good intraobserver reliability was found (Cohen kappa = 0.851, P < .001, 95% CI 0.777-0.926). Conclusion: Almost half (49.3%) of patients had a presentation dominantly involving the hindfoot (A) with various combinations of midfoot and/or forefoot deformity (B), (C) with or without subtalar joint involvement (D). The new system may cover all possible combinations of the PCFD, providing a comprehensive description and guiding treatment in a systematic and individualized manner, but this initial study suggests an opportunity to improve overall interobserver reliability.
Details
- Title: Subtitle
- Intra- and Interobserver Reliability of the New Classification System of Progressive Collapsing Foot Deformity
- Creators
- Hee Young Lee - University of IowaNacime Salomao Barbachan Mansur - University of IowaMatthieu Lalevee - University of IowaKevin N. Dibbern - Univ Iowa, Dept Orthopaed & Rehabil, 200 Hawkins Dr John Pappajohn Pavilion,Room 01066, Iowa City, IA 52242 USAMark S. Myerson - University of Colorado DenverScott J. Ellis - Hospital for Special SurgeryJohn E. Femino - University of IowaCesar de Cesar Netto - Univ Iowa, Dept Orthopaed & Rehabil, 200 Hawkins Dr John Pappajohn Pavilion,Room 01066, Iowa City, IA 52242 USAProgressive Collapsing Foot Deformity Consensus Group
- Resource Type
- Abstract
- Publication Details
- Foot & ankle international, Vol.43(4), pp.582-589
- Publisher
- Sage
- DOI
- 10.1177/10711007211058154
- PMID
- 35097796
- ISSN
- 1071-1007
- eISSN
- 1944-7876
- Number of pages
- 8
- Language
- English
- Date published
- 04/01/2022
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984303989302771
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