Evidence map›Paper›PMID 35549448›Full record

ArticleBone & joint open2022

Development of the Revision Hip Complexity Classification using a modified Delphi technique.

Justin W Y Leong, Rohit Singhal, Michael R Whitehouse, Jonathan R Howell, Andrew Hamer, Vikas Khanduja, Tim N Board, BHS RHCC expert panel.

Abstract read
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Article in Bone & joint open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Justin W Y LeongDepartment of Trauma and Orthopaedic Surgery, Countess of Chester Hospital NHS Foundation Trust, Chester, UK.ORCID 0000-0002-7571-7204
Rohit SinghalDepartment of Trauma and Orthopaedic Surgery, Wrightington Hospital, Wigan, UK.
Michael R WhitehouseMusculoskeletal Research Unit, Bristol Medical School, University of Bristol, Bristol, UK.
Jonathan R HowellPrincess Elizabeth Orthopaedic Centre, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.
Andrew HamerSheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK.
Vikas KhandujaAddenbrooke's - Cambridge University Hospital NHS Foundation Trust, Cambridge, UK.
Tim N BoardDepartment of Trauma and Orthopaedic Surgery, Wrightington Hospital, Wigan, UK.
BHS RHCC expert panel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe aim of this modified Delphi process was to create a structured Revision Hip Complexity Classification (RHCC) which can be used as a tool to help direct multidisciplinary team (MDT) discussions of complex cases in local or regional revision networks.

methodsThe RHCC was developed with the help of a steering group and an invitation through the British Hip Society (BHS) to members to apply, forming an expert panel of 35. We ran a mixed-method modified Delphi process (three rounds of questionnaires and one virtual meeting). Round 1 consisted of identifying the factors that govern the decision-making and complexities, with weighting given to factors considered most important by experts. Participants were asked to identify classification systems where relevant. Rounds 2 and 3 focused on grouping each factor into H1, H2, or H3, creating a hierarchy of complexity. This was followed by a virtual meeting in an attempt to achieve consensus on the factors which had not achieved consensus in preceding rounds.

resultsThe expert group achieved strong consensus in 32 out of 36 factors following the Delphi process. The RHCC used the existing Paprosky (acetabulum and femur), Unified Classification System, and American Society of Anesthesiologists (ASA) classification systems. Patients with ASA grade III/IV are recognized with a qualifier of an asterisk added to the final classification. The classification has good intraobserver and interobserver reliability with Kappa values of 0.88 to 0.92 and 0.77 to 0.85, respectively.

conclusionThe RHCC has been developed through a modified Delphi technique. RHCC will provide a framework to allow discussion of complex cases as part of a local or regional hip revision MDT. We believe that adoption of the RHCC will provide a comprehensive and reproducible method to describe each patient's case with regard to surgical complexity, in addition to medical comorbidities that may influence their management. Cite this article:

Indexed as

acetabulumAnesthesiologistsbone lossBone lossdebridement, antibiotics, and implant retentionDelphi methodologyDelphi processDislocationfemurHipInfectionmedical comorbiditiesPeriprosthetic fractureperiprosthetic fracturesRevision Hip Complexity Classificationrevision hip surgeryRevision total hip arthroplasty

Identifiers

PMID35549448
PMCPMC9134833

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.