Evidence map›Paper›PMID 28904629›Full record

ArticleJournal of children's orthopaedics2017

Reliability of patellar height indices in children with cerebral palsy and spina bifida.

S A Rethlefsen, K K Barrett, T A L Wren, G Blumstein, D Gargiulo, D D Ryan, R M Kay

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Article in Journal of children's orthopaedics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

S A RethlefsenChildren's Orthopaedic Center, Children's Hospital, Los Angeles, California, USA.
K K BarrettDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California, USA.
T A L WrenChildren's Orthopaedic Center, Children's Hospital, and Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California, USA.
G BlumsteinDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California, USA.
D GargiuloChildren's Hospital, New Orleans, Louisiana, USA.
D D RyanChildren's Orthopaedic Center, Children's Hospital, and Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California, USA.
R M KayChildren's Orthopaedic Center, Children's Hospital, and Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Koshino (KI) and Caton-Deschamps (CDI) indices are used to measure patellar height in children, with the CDI showing excellent reliability in typically developing (TD) children. Reliability of such measures in children with cerebral palsy (CP) and spina bifida (SB) is unknown.

methodsLateral knee radiographs were reviewed retrospectively for children with TD (n = 49), CP (n = 48) and SB (n = 42). Five raters took measurements from radiographs twice, at least two weeks apart. Measurements included the CDI, Insall-Salvati Index (ISI) and KI. Systematic variability (bias) and random variability were examined using repeated measures ANOVA, 95% limits of agreement (LOA) and coefficients of variation (CV).

resultsMean values of all three indices differed among raters (p < 0.0001). A significant difference was seen between the first and second measurements for CDI and KI indicating a learning effect. LOA ranges were large for the CDI (intra-rater: 0.37-0.95, inter-rater: 0.60-1.04) and ISI (intra-rater: 0.25-0.49, inter-rater: 0.51-0.57) for all patient groups. The KI showed a clinically acceptable range for TD participants (intra-rater: 0.14-0.16, inter-rater: 0.11-0.14) with larger ranges for CP (intra-rater: 0.26-0.33, inter-rater 0.0.2-0.35) and SB patients (intra-rater: 0.23-0.27, inter-rater: 0.19-0.25). CVs were lowest (best) for KI (3.8% to 7.4%) and highest (worst) for CDI (14.7% to 23.1%) for all three groups. Results were similar for patients with both open and closed physes.

conclusionsThe KI is the most reliable patellar height measure for paediatric patients with TD, CP and SB, with either open or closed physes. The KI is more complex and experience may be important for valid, reliable measurement.

Indexed as

cerebral palsyPatellar height indexreliabilityspina bifida

Identifiers

PMID28904629
PMCPMC5584492

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