{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:41:59Z","timestamp":1788547319725,"version":"build-2803163510"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The purpose of this study was to analyze the interobserver reliability and intraobserver repeatability of the China-Japan Friendship Hospital (CJFH) typing classification system for nontraumatic osteonecrosis of the femoral head (ONFH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Image data of 50 hips were randomly selected in 289 patients (433 hips) with ONFH who underwent treatment in the China-Japan Friendship Hospital from 2012 to 2016. Bilateral hip plain radiography, magnetic resonance imaging (MRI), or computerized tomography (CT) were performed in all hips. The assessments were performed by 8 new residents independently, and the repeatability was assessed at 4-week intervals. Evaluation indicators included the size, location, and extent of necrotic lesions. Kappa values were used to determine the reliability and repeatability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>According to the CJFH classification system, 2,800 evaluations were performed with an average interobserver Kappa value of 0.711, and 400 assessments were performed with an average intraobserver Kappa value of 0.748. Reliability analysis indicated a higher reliability and repeatability of this classification system. Critical factors affecting the consistency included the accurate selection of the median coronal plane and definitive tri-pillar division of the femoral head.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The CJFH classification system is a simple and direct evaluation model for ONFH with substantial inter- and intraobserver reliability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.20.00051","type":"journal-article","created":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T17:03:23Z","timestamp":1649351003000},"page":"40-46","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":15,"title":["Reliability and Repeatability of the China-Japan Friendship Hospital Typing Classification for Nontraumatic Osteonecrosis of the Femoral Head"],"prefix":"10.2106","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1952-419X","authenticated-orcid":false,"given":"Li-hua","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7783-5805","authenticated-orcid":false,"given":"Zi-rong","family":"Li","sequence":"additional","affiliation":[{"name":"Centre for Osteonecrosis and Joint-preserving & Reconstruction, Orthopaedic Department, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Sun","sequence":"additional","affiliation":[{"name":"Centre for Osteonecrosis and Joint-preserving & Reconstruction, Orthopaedic Department, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3639-4665","authenticated-orcid":false,"given":"Yun-ting","family":"Wang","sequence":"additional","affiliation":[{"name":"Centre for Osteonecrosis and Joint-preserving & Reconstruction, Orthopaedic Department, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6777-2847","authenticated-orcid":false,"given":"Fu-qiang","family":"Gao","sequence":"additional","affiliation":[{"name":"Centre for Osteonecrosis and Joint-preserving & Reconstruction, Orthopaedic Department, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,4,6]]},"reference":[{"issue":"3","key":"bib1-20250430","doi-asserted-by":"crossref","first-page":"473","DOI":"10.2106\/00004623-199603000-00022","article-title":"Non-traumatic avascular necrosis of the femoral head","volume":"78","author":"Maillefert","year":"1996","journal-title":"J Bone Joint Surg Am."},{"issue":"3","key":"bib2-20250430","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1007\/s00264-013-1775-y","article-title":"The natural history of asymptomatic osteonecrosis of the femoral head","volume":"37","author":"Kang","year":"2013","journal-title":"Int Orthop."},{"issue":"12","key":"bib3-20250430","doi-asserted-by":"crossref","first-page":"2165","DOI":"10.2106\/JBJS.I.00575","article-title":"The natural history of untreated asymptomatic osteonecrosis of the femoral head: a systematic literature review","volume":"92","author":"Mont","year":"2010","journal-title":"J Bone Joint Surg Am."},{"issue":"5","key":"bib4-20250430","first-page":"498","article-title":"[S3 Guideline. 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