Influence of investigator experience on reliability of adult acquired flatfoot deformity measurements using weightbearing computed tomography

Abstract

BackgroundOur purpose was to assess the reliability of measurements of adult-acquired flatfoot deformity (AAFD) taken by investigators of different levels of clinical experience using weightbearing computed tomography (WBCT). MethodsNineteen AAFD patients underwent WBCT. Three investigators with different levels of clinical experience made AAFD measurements in axial, coronal, and sagittal planes. Intra- and interobserver reliability were assessed. Mean values for each measurement were compared between investigators. ResultsAfter a training protocol, substantial to perfect intra- and interobserver reliability was observed for most measures, regardless of the investigator’s experience level. Significant differences between investigators were observed in 2 of 21 measured parameters: medial cuneiform–first metatarsal angle (P=0.003) and navicular–medial cuneiform angle (P=0.001). ConclusionsAAFD radiographic measurements can be performed reliably by investigators with different levels of clinical experience using WBCT. Level of evidenceLevel II, prospective comparative study.