Validity of Hepple Classification Used in the Diagnosis of Talus Osteochondral Lesions.

Abstract

It was aimed to investigate the intra-observer and inter-observer validity of the Hepple classification used in talus osteochondral lesions. This study included 32 patients with osteochondral lesions in the talus after exclusion criteria. A PowerPoint presentation was prepared from the MRI views of the patients. Six observers, divided into two groups according to their experience, were asked to categorize the cases according to Hepple classification. The slides were shuffled and the observers were asked to reevaluate after 6 weeks. Fleiss kappa (κ) coefficient was used for the inter-observer validity and Cohen's kappa (κ) coefficient for the intra-observer validity. In the overall inter-observer reliability was at a moderate level of agreement (set one κ=0.511, set two κ=0.406). In the intra-observer evaluation, one observer from the experienced group showed almost perfect agreement (κ=0.809), one observer from the less experienced group had moderate agreement (κ=0.556), and all other observers had substantial agreement (κ=0.556 - 0.730). When all observers were examined, it was seen that there was a substantial agreement in the mean intra-observer evaluation (κ=0.661). While the intra-observer results showed substantial agreement, the inter-observer results showed moderate agreement. Although the Hepple classification system is frequently used, the need for a more reliable classification system for osteochondral lesions of the talus remains.