https://orcid.org/0000-0003-1914-5413
Dear Editor,
Vancouver classification system (VCS) is still the most used evaluation method of periprosthetic hip fractures in clinical practice; nevertheless Unified Classification System (UCS) has been developed as a more comprehensive and complex system. UCS hasn't still completely replaced such a well-known and widespread classification as VCS. In order to provide evidence about the safety and efficacy of UCS we compared the validity and reliability of both classification systems, evaluating their use on the same population sample. This study demonstrated how, in VCS and UCS, validity and reproducibility are at least equalCitation1.
Modified UCS seems to improve UCS, including some parameters not evaluated in that classificationCitation2. It has been proved as a valid and reliable systemCitation3. Currently, the reliability and validity of the two systems have not been compared. A comparison between the original classification and its modified version could help orthopedic surgeons choosing the most updated and comprehensive one. Moreover, the modified UCS needs an external validation to further confirm its high validity and reliability.
The authors disagree with the colleague’s last statement: actually, both trainee and expert surgeons should master a classification that is a good balance among comprehensiveness, clarity, reliability, validity and spread. Finally, UCS expand the classification to most of the joints: modifications of this system should be intended also to be applicable to the other districts. From the authors point of view, UCS is a great resource and should be mastered by registrars and consultants both.
Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Science, Sapienza University of Rome, Rome, Italy
Department of Orthopaedics and Traumatology, Policlinico Umberto I, Rome, Italy
[email protected]
Massimiliano Mangone
Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Science, Sapienza University of Rome, Rome, Italy
Alessandro Calistri, Pietro Persiani and Ciro Villani
Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Science, Sapienza University of Rome, Rome, Italy
Department of Orthopaedics and Traumatology, Policlinico Umberto I, Rome, Italy
Transparency
Declaration of funding
There is no funding to disclose.
Declaration of financial/other relationships
The authors of this manuscript have no relevant financial or other relationships to disclose.
Acknowledgements
None reported.
References
- De Meo D, Zucchi B, Castagna V, et al. Validity and reliability of the Unified Classification System applied to periprosthetic femur fractures: a comparison with the Vancouver system. Curr Med Res Opin. 2020;1. [published online ahead of print, 2020 Jun 11].
- Huang JF, Jiang XJ, Shen JJ, et al. Modification of the Unified Classification System for periprosthetic femoral fractures after hip arthroplasty. J Orthop Sci. 2018;23(6):982–986.
- Fan MQ, Fan XH, Chen XL, et al. The reliability and validity of the modified Unified Classification System for periprosthetic femoral fractures after hip arthroplasty. J Orthop Sci. 2020;S0949–2658(20)30079-8. [published online ahead of print, 2020 Mar 27].