## 3 Results  
A total of 29 patients met the inclusion criteria and none were excluded from the statistical analysis (Figure 2).  
Figure 2: Study’s flow chart.  
A total of 6 were males, and 23 were females. The patients' ages ranged from 15 to 40 years old (average age 23.5 \(\pm\) 8.2) (Table 1). Considering the raters' average, the preoperative CDI values significantly differed from the postoperative ones (pre: 1.31 \(\pm\) 0.04; post: 1.22 \(\pm\) 0.04; \(p\) = 0.005). Moreover, this difference became even more significant considering patients who underwent medialization and lowering ATA osteotomy (pre: 1.43 \(\pm\) 0.12; post: 1.19 \(\pm\) 0.09; \(p\) < 0.0001).  
Concerning the preoperative CDI measurement, an absolute agreement between the six observers (meaning the tendency of raters to assign the same exact score) showed an interclass correlation coefficient (ICC) of 0.941 (CI 95%: 0.893-0.971) for the raters' average, and 0.728 (CI 95%: 0.584-0.849) for the individual raters. All these values were significantly different from 0 (meaning no agreement between the raters), showing no systematic difference between the raters' measurements (\(p\) < 0.001).  
Considering the postoperative measures, the ICCs among the six observers were lower but remained high at 0.898 (CI 95%: 0.827-0.946) and 0.594 (CI 95%: 0.443-0.745) for the raters' average and individual raters, respectively. This could be advocated to post-surgical confounding factors with no statistical meaning. Nevertheless, the results were statistically significant (\(p\) < 0.001) (Table 2).  
Moreover, comparing the measurements between the senior and junior raters, among the senior raters, the ICC for absolute agreement had a result of 0.931 (CI 95%: 0.873-0.966, \(p\) < 0.001) for the raters' average and 0.819 (CI 95%: 0.696-0.903, \(p\) < 0.001) for the individual raters. In addition, among the junior raters, the ICC value for absolute agreement was 0.888 (CI 95%: 0.775-0.948, \(p\) < 0.001) for the raters' average and 0.725 (CI 95%: 0.537-0.857, \(p\) < 0.001) for the individual raters (Table 4).  
\begin{table}
\begin{tabular}{c c} \hline
**Patients** & **N = 29** \\ \hline Mean age & 23.5 \(\pm\) 8.2 \\ \hline Males & 6 \\ \hline Females & 23 \\ \hline ATA transposition + MPFL reconstruction & 13 \\ \hline ATA transposition & 13 \\ \hline MPFL reconstruction & 3 \\ \hline \end{tabular}
\end{table}
Table 1: Patients’ demographic and surgical procedures.  
\begin{table}
\begin{tabular}{c c c c} \hline  & **RA** & **IR** & \(p\)**-Value** \\ \hline Preoperative & 0.941 & 0.728 & \textless{}0.001 \\ \hline Postoperative & 0.898 & 0.594 & \textless{}0.001 \\ \hline \end{tabular}
\end{table}
Table 2: Preoperative and postoperative interclass correlation coefficient (ICC) for raters’ average (RA) and individual raters (IR) between the six raters.  
\begin{table}
\begin{tabular}{c c c} \hline  & **Fleiss Kappa** & \(p\)**-Value** \\ \hline Six raters & 0.636 & \(p\) < 0.001 \\ \hline Seniors & 0.580 & \(p\) < 0.001 \\ \hline Juniors & 0.704 & \(p\) < 0.001 \\ \hline \end{tabular}
\end{table}
Table 3: Fleiss kappa values between the six raters and between seniors and juniors separately.  
Although the ICC values in the junior group were lower, no significant difference was detected from the seniors' measurements, because confidence intervals widely overlapped. Furthermore, concerning the Fleiss kappa, the value obtained by the senior raters was 0.580 (\"moderate agreement\"), while considering only the junior raters, the Fleiss kappa was 0.704 (\"substantial agreement\") (\(p<0.001\)) (Table 3).