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

Abstract

Background: We aimed to investigate the intraobserver and interobserver validity of the Hepple classification used in talus osteochondral lesions.

Methods: This study included 32 patients with osteochondral lesions in the talus after the exclusion criteria were applied. A slideshow presentation was prepared from the magnetic resonance imaging views of the patients. Six observers, divided into two groups according to their experience, were asked to categorize the cases according to the Hepple classification. The slides were shuffled, and the observers were asked to reevaluate after 6 weeks. Fleiss kappa (κ) coefficient was used for the interobserver validity and Cohen κ coefficient for the intraobserver validity.

Results: Overall, interobserver reliability was at a moderate level of agreement (set one κ = 0.511, set two κ = 0.406). In the intraobserver 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 of the other observers had substantial agreement (κ=0.556-0.730). When all of the observers were examined, it was seen that there was substantial agreement in the mean intraobserver evaluation (κ = 0.661).

Conclusions: Whereas the intraobserver results showed substantial agreement, the interobserver 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.