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Larsson E, Brandt Knutsson S, Brorsson A, Johansson C, Nilsson Helander K. Establishment of the Patient Acceptable Symptom State (PASS) for the Achilles Tendon Total Rupture Score in a Swedish Population. Orthop J Sports Med 2024; 12:23259671241253280. [PMID: 39070900 PMCID: PMC11273557 DOI: 10.1177/23259671241253280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 11/16/2023] [Indexed: 07/30/2024] Open
Abstract
Background As the use of patient-reported outcome measures (PROMs) is increasing in orthopaedic research, there is also a growing need for a standardized interpretation of these scores, such as the Patient Acceptable Symptom State (PASS), defined as the value beyond which patients consider themselves well. The Achilles tendon Total Rupture Score (ATRS) is the only PROM specific for Achilles tendon ruptures. Purpose To establish the PASS for the ATRS in a Swedish population. Study Design Cross-sectional study; Level of evidence, 3. Methods Patients treated for an acute Achilles tendon rupture at a single institution in Sweden (injured between July 1, 2018, and December 31, 2020) were asked to participate in this study. The patients completed a questionnaire consisting of the ATRS and an anchor question: "How satisfied are you with the result of your treatment?" Receiver operating characteristic curve analysis was performed to calculate the PASS threshold for a positive response to the anchor question. Results Of 516 eligible patients, 316 (61%) were included. The time from injury to completion of the questionnaire ranged from 12 to 27 months. The PASS threshold for the ATRS was found to be 75. The median ATRS of all patients was 80; 66% of patients reached an ATRS ≥75. Overall, 79% of patients were satisfied with the results of their treatment. Conclusion The estimated PASS for the ATRS was 75 in the general Swedish population at 12 to 27 months after an acute Achilles tendon rupture.
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Affiliation(s)
- Elin Larsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Institute of Clinical Sciences at Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Sara Brandt Knutsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Institute of Clinical Sciences at Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Annelie Brorsson
- IFK Kliniken Rehab, Gothenburg, Sweden
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, Gothenburg University, Sweden
| | - Christer Johansson
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, Gothenburg University, Sweden
| | - Katarina Nilsson Helander
- Department of Orthopaedics, Sahlgrenska University Hospital, Institute of Clinical Sciences at Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
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Arbab D, Lichte P, Gutteck N, Bouillon B, Arbab D. Reliability and validation of the German Achilles tendon Total Rupture Score. Knee Surg Sports Traumatol Arthrosc 2024; 32:454-460. [PMID: 38270292 DOI: 10.1002/ksa.12059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/21/2023] [Accepted: 01/03/2024] [Indexed: 01/26/2024]
Abstract
PURPOSE Patient-related outcome measures (PROMs) are important instruments to evaluate efficacy of orthopaedic procedures. The Achilles tendon Total Rupture Score (ATRS) is a PROM developed to evaluate outcomes after treatment of Achilles tendon ruptures (ATRs). Purpose of this study is to develop and culturally adapt the German version of the ATRS and to evaluate reliability and validity. METHODS The ATRS was translated by forward-backward translation based on common guidelines. In this retrospective study, 48 patients with a surgical intervention after ATR were recruited. Reliability was evaluated by intraclass correlation coefficient (ICC) and Cronbach's alpha. Construct validity was valued by determining Pearson correlation coefficient with the German version of the Foot and Ankle Outcome Score (FAOS) and the Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A). RESULTS The German Version of the ATRS has an excellent internal consistency (Cronbach's alpha 0.96) as well as an excellent test-retest-reliability (ICC 0.98). It has a moderately strong correlation with the VISA-A (r = 0.73) as well as with the FAOS subclasses (r = 0.6-0.79). CONCLUSION The German version of the ATRS demonstrated good psychometric properties. It proofed to be a valid and reliable instrument for use in patients with Achilles tendon Rupture. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- Dorothe Arbab
- Department of Orthopaedic and Trauma Surgery, Aachen University Hospital, Aachen, Germany
| | - Philip Lichte
- Department of Orthopaedic and Trauma Surgery, Aachen University Hospital, Aachen, Germany
| | - Natalia Gutteck
- Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Bertil Bouillon
- Department of Traumatology and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University of Witten/Herdecke, Cologne, Germany
| | - Dariusch Arbab
- Department of Orthopedic and Trauma Surgery, St. Elisabeth-Hospital Herten, Member Faculty of Health Witten/Herdecke University, Herten, Germany
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Zhang Y, Ren J, Zang Y, Guo W, Disantis A, Martin RL. Cross-Culturally Adapted Versions of Patient Reported Outcome Measures for the Lower Extremity. Int J Sports Phys Ther 2023; V18:653-686. [PMID: 37425110 PMCID: PMC10324371 DOI: 10.26603/001c.74528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 03/08/2023] [Indexed: 07/11/2023] Open
Abstract
Background A large number of patient reported outcome measures (PROMs) have been developed in the English language for various lower extremity orthopaedic pathologies. Twenty different PROMs were recommended for 15 specific musculoskeletal lower extremity pathologies or surgeries. However, the availability of cross-culturally adapted versions of these recommended PROMs is unknown. Purpose The purpose of this study was to identify the cross-culturally adapted versions of recommended PROMs for individuals experiencing orthopedic lower extremity pathologies or undergoing surgeries, and to identify the psychometric evidence that supports their utilization. Study design Literature Review. Methods PubMed, Embase, Medline, Cochrane, CINAHL, SPORTDisucs and Scopus were searched for cross-culturally adapted translated studies through May 2022. The search strategy included the names of the 20 recommended PROMs from previous umbrella review along with the following terms: reliability, validity, responsiveness, psychometric properties and cross-cultural adaptation. Studies that presented a non-English language version of the PROM with evidence in at least one psychometric property to support its use were included. Two authors independently evaluated the studies for inclusion and independently extracted data. Results Nineteen PROMS had cross-culturally adapted and translated language versions. The KOOS, WOMAC, ACL-RSL, FAAM, ATRS, HOOS, OHS, MOXFQ and OKS were available in over 10 different language versions. Turkish, Dutch, German, Chinese and French were the most common languages, with each language having more than 10 PROMs with psychometric properties supporting their use. The WOMAC and KOOS were both available in 10 languages and had all three psychometric properties of reliability, validity, and responsiveness supporting their use. Conclusion Nineteen of the 20 recommended instruments were available in multiple languages. The PROM most frequently cross-culturally adapted and translated were the KOOS and WOMAC. PROMs were most frequently cross-culturally adapted and translated into Turkish. International researchers and clinicians may use this information to more consistently implement PROMs with the most appropriate psychometric evidence available to support their use. Level of evidence 3a.
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Affiliation(s)
- Yongni Zhang
- Rangos School of Health Sciences Duquesne- China Health Institute
| | - Jiayi Ren
- Shuguang Hospital of Shanghai University of Traditional Chinese Medicine
| | - Yaning Zang
- Department of Kinesiology Shanghai University of Sport
| | - Wenhao Guo
- Rangos School of Health Sciences Duquesne- China Health Institute
| | - Ashley Disantis
- Department of Physical Therapy Duquesne University
- UPMC Children's Hospital of Pittsburgh
| | - Robroy L Martin
- Department of Physical Therapy Duquesne University
- UPMC Center for Sports Medicine
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Altered Ankle Muscle Activation at 2-Year Post Achilles Tendon Repair: An Age, Gender, and Activity Level-Matched Comparison With Healthy Subjects. J Sport Rehabil 2023; 32:305-314. [PMID: 36623511 DOI: 10.1123/jsr.2022-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 01/11/2023]
Abstract
CONTEXT The study purpose was to compare the ankle muscle activation and dynamic ankle joint stability of subjects who underwent endoscopy-assisted Achilles tendon repair (ATR; at ≥ 2 y postsurgery) with age, gender, and activity level-matched healthy control group subjects. DESIGN Prospective, cross-sectional study. All functional tests were performed on the involved ankle of the ATR group, and at the matched side of healthy age, gender, and activity-level control group subjects. METHODS Fifteen men in each group were evaluated for medial and lateral gastrocnemius, soleus, tibialis anterior, and peroneus longus muscle activation during modified star excursion balance test and heel-rise test performance. The weight-bearing lunge test (ankle dorsiflexion) and heel-rise test distance (ankle plantar flexion) also determined weight-bearing, active ankle mobility magnitudes. The Achilles Tendon Total Rupture Score and Foot and Ankle Outcome Score provided patient-reported outcome perceptions specific to Achilles tendon rupture and comprehensive foot and ankle symptoms and function, respectively. RESULTS Medial (P = .005) and lateral (P = .012) gastrocnemius displayed greater activation amplitudes in the ATR group during the star excursion balance test, and peroneus longus displayed greater activation amplitudes during the heel-rise test (P = .006). The star excursion balance test reach distance was comparable between groups. Active weight-bearing ankle plantar flexion (heel-rise test) and dorsiflexion (weight-bearing lunge test) mobility magnitudes were lower in the ATR group. CONCLUSIONS Subjects who underwent endoscopy-assisted percutaneous ATR had reduced active weight-bearing ankle dorsiflexion and plantar flexion mobility magnitudes and greater gastrocnemius and peroneus longus neuromuscular activation when performing the same tasks as healthy control group subjects. As surgical approaches evolve to less invasive, soft tissue preserving methods with less tissue morbidity and faster healing, rehabilitation approaches may likewise need to evolve. LEVEL OF EVIDENCE Level III.
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Suphinnapong P, Teeranon N, Teerakidpisan S, Tansuthunluck S, Apinun J. Validity and reliability of the Thai version of the Achilles tendon total rupture score. Knee Surg Sports Traumatol Arthrosc 2023; 31:2228-2235. [PMID: 36651942 DOI: 10.1007/s00167-023-07319-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 01/09/2023] [Indexed: 01/19/2023]
Abstract
PURPOSE The purpose of this study was to translate and cross-culturally adapt the Achilles Tendon Total Rupture Score (ATRS), a patient-reported outcome measurement (PROM) designed specifically to assess outcomes in patients with Achilles tendon rupture, into the Thai language and then determine its validity and reliability. METHODS The ATRS was translated into the Thai version (Thai-ATRS) according to internationally recognized guidelines. The study included 50 patients with Achilles tendon rupture from 2003 to 2017. The web-based online assessments were conducted two weeks apart. Construction validity was determined by assessing the correlation between the Thai-ATRS and the Thai version of the Foot and Ankle Outcome Score (Thai-FAOS). Reliability was determined with Cronbach's alpha and intraclass correlation coefficients (ICC). RESULTS The validity test displayed a strong correlation between the Thai-ATRS and the Thai-FAOS (r = 0.87). The reliability test showed good internal consistency with a Cronbach's alpha of 0.95 and excellent internal consistency with an ICC of 0.95, which represented excellent test-retest reliability. The MDC was 10.7 at the individual level and 1.5 at the group level. CONCLUSION The Thai-ATRS was demonstrated to be valid and reliable for assessing functional outcomes in Thai patients with Achilles tendon rupture. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Pawichaya Suphinnapong
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Pathumwan, Bangkok, 10330, Thailand
| | - Niphon Teeranon
- Rehabilitation Center, Siriraj-Piyamaharajkarun Hospital, Bangkok, Thailand
| | | | | | - Jirun Apinun
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Pathumwan, Bangkok, 10330, Thailand.
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Park YH, Cho HW, Choi JW, Kim HJ. Validation and cross-cultural adaptation of the Korean translation of the Achilles tendon Total Rupture Score. BMC Musculoskelet Disord 2021; 22:876. [PMID: 34649549 PMCID: PMC8518316 DOI: 10.1186/s12891-021-04765-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/29/2021] [Indexed: 11/22/2022] Open
Abstract
Background The Achilles tendon Total Rupture Score (ATRS) is a widely used patient-reported outcome measure to assess clinical outcomes of Achilles tendon rupture, but it has not been validated in Korean yet. The purpose of this study was to translate the ATRS into Korean and evaluate its reliability and validity in a Korean population. Methods The ATRS was translated into Korean according to recommended guidelines for forward-backward translation. Thirty-eight patients who underwent surgical treatment for Achilles tendon rupture from 2017 to 2019 were enrolled. Reliability was evaluated by the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable change (MDC). Construct validity was assessed with Spearman rank correlations with the Korean version of the Foot and Ankle Outcome Score (FAOS) and Numeric Rating Scale (NRS) for pain in daily activity. Results The Korean translation of the ATRS had excellent test-retest reliability (ICC = 0.84) and acceptable internal consistency (Cronbach’s alpha = 0.84). The SEM was 6.61, and the MDC was 18.32 at the individual level and 2.97 at the group level. The Korean translation of the ATRS was strongly correlated with the FASO (r = 0.88). Correlation with the NRS in daily activity (r = − 0.66) was moderate. Conclusion The Korean translation of the ATRS showed sufficient reliability and validity for use in the Korean population. Level of evidence II. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04765-w.
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Affiliation(s)
- Young Hwan Park
- Department of Orthopaedic Surgery, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Hyun Woo Cho
- Department of Orthopaedic Surgery, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Jung Woo Choi
- Department of Orthopaedic Surgery, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Hak Jun Kim
- Department of Orthopaedic Surgery, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea.
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Jamjoom BA. The Influence of Early Weightearing, Controlled Motion, and Timing of Orthosis Removal on the Nonoperative Management of Achilles Tendon Rupture: A Systematic Review. J Foot Ankle Surg 2021; 60:777-786. [PMID: 33785241 DOI: 10.1053/j.jfas.2020.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 04/08/2020] [Indexed: 02/03/2023]
Abstract
This is a systematic review of the non-operative treatment for Achilles tendon rupture aimed at assessing the effect of early weightbearing, controlled motion and orthosis removal on 5 outcome measures. The literature was searched for relevant RCTs and prospective cohort studies. The primary outcome measure was the re-rupture rate. The secondary outcome measures were the rates for DVT, duration before return to work (RTW), return to sports (RTS) and the mean Achilles Tendon Rupture Score (ATRS). Eighteen publications reporting a total of 1068 patients were reviewed. The pooled rates were: re-rupture: 7.3%, DVT: 5.5%, RTW: 10.3 weeks, RTS: 47.7% and ATRS: 78.7. Early compared to late weightbearing was associated with significantly lower rates of DVT, RTW and ATRS but no difference in the rates of re-rupture and RTS. Early controlled motion compared to no motion was associated with significantly lower rates of re-rupture, RTW and ATRS but no difference in the rates of DVT and RTS. Early compared to late orthosis removal was associated with significantly higher rates of re-rupture and ATRS as well as a lower rate of RTW but no difference in the rates of DVT and RTS. The findings relating to re-rupture, DVT, RTW and RTS support the adoption of early weightbearing and controlled motion in the non-operative treatment for Achilles tendon rupture. Early removal of orthosis is not advisable due to an increased risk of re-rupture. The ATRS results were considered inconclusive probably due to inconsistencies in the reporting or heterogeneity in the study population.
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Affiliation(s)
- Bakur A Jamjoom
- Specialist Registrar, Department of Trauma and Orthopaedics, East Midland (North) Deanery Affiliated Hospitals, Nottingham, UK.
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Buckinx F, Lecoq G, Bornheim S, Van Beveren J, Valcu A, Daniel C, Bruyère O, Reginster JY, D'Hooghe P, Kaux JF. French translation and validation of the Achilles Tendon Total Rupture Score "ATRS". Foot Ankle Surg 2020; 26:662-668. [PMID: 31492520 DOI: 10.1016/j.fas.2019.08.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 07/05/2019] [Accepted: 08/19/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND To provide a cross-cultural French adaptation of the Achille's Tendon Total Rupture Score (ATRS) and to assess its psychometric performances. METHOD The ATRS questionnaire was first translated and inter-culturally adapted into French according to international guidelines. Then, 95 subjects were recruited to complete the French version of the ATRS twice (2 weeks of interval). The SF-36 and VISA-A were used as comparative questionnaires. The psychometric properties of the questionnaire were evaluated (test-retest reliability, internal consistency, construct validity, floor/ceiling effects). RESULTS Thetest-retest reliability was excellent (ICC of 0,966 (95% CI:0.644-0.879)) and the internal consistency very high (Cronbach's alpha of 0,98). The convergent and divergent construct validity were also confirmed. Finally, none of the subjects obtained the lowest score (0) or the maximal score (100) to the questionnaire. CONCLUSION A valid and reliable French version of the ATRS is now available.
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Affiliation(s)
- F Buckinx
- Department of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Belgium.
| | - G Lecoq
- Department of Sport Rehabilitation Sciences, University of Liège, Belgium
| | - S Bornheim
- Department of Sport Rehabilitation Sciences, University of Liège, Belgium; Department of Physical Medicine and Rehabilitation, SportS, FIFA Medical Center of Excellence Liege University Hospital Center, Liege, Belgium
| | | | - A Valcu
- Orthopaedic Surgery Department, University Hospital of Liège, Liege, Belgium
| | - C Daniel
- Orthopaedic Surgery Department, University Hospital of Liège, Liege, Belgium
| | - O Bruyère
- Department of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Belgium
| | - J Y Reginster
- Department of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Belgium; Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - P D'Hooghe
- Department of Orthopaedic Surgery, Aspetar Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - J F Kaux
- Department of Sport Rehabilitation Sciences, University of Liège, Belgium; Department of Physical Medicine and Rehabilitation, SportS, FIFA Medical Center of Excellence Liege University Hospital Center, Liege, Belgium
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Hansen MS, Nilsson Helander K, Karlsson J, Barfod KW. Performance of the Achilles Tendon Total Rupture Score Over Time in a Large National Database: Development of an Instruction Manual for Accurate Use. Am J Sports Med 2020; 48:1423-1429. [PMID: 32255669 DOI: 10.1177/0363546520912222] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The Achilles tendon Total Rupture Score (ATRS) is a commonly used patient-reported outcome measure for patients with an acute Achilles tendon rupture. The score consists of 10 questions, the last 3 of which include activities that some patients cannot or do not do. No instruction manual has been developed for the ATRS. HYPOTHESIS/PURPOSE The purpose was to evaluate the ATRS at 4, 12, and 24 months after a rupture. The hypothesis was that the results at 4 months would be inconsistent when compared with the results at 1 year and 2 years. We also aimed to develop a manual that explains how to use the ATRS. STUDY DESIGN Cohort study (Diagnosis); Level of evidence, 3. METHODS This was a mixed-methods study. The first section was a registry study, where prospectively collected data were analyzed. Data were collected 4, 12, and 24 months after rupture. The original score based on 10 items was compared with a score based on the first 7 items adjusted to the same scale as the original score. Density plots and scatterplots were made and differences between the scores were tested using the Mann-Whitney U test. The second section of the study consisted of discussions among the authors, which resulted in a manual for the ATRS. RESULTS In total, 2790 complete ATRSs were included. The 7-item score significantly overestimated the value of the 10-item score at all time points (P < .001), but only at 4 months was the difference clinically relevant (9.7 points). CONCLUSION When the ATRS is used for short-term evaluation, there is a risk of results being inconsistent because of the last 3 questions. A manual explaining how to use the ATRS was therefore developed. We recommend that the full ATRS together with the manual should be used in future research rather than eliminating the 3 last questions.
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Affiliation(s)
- Maria Swennergren Hansen
- Physical Medicine & Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark.,Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark
| | | | - Jón Karlsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kristoffer Weisskirchner Barfod
- Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark
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Arslan İ, Yücel I, Öztürk TB, Karahan N, Orak MM, Midi A. The Effects of Corticosteroid Injection in the Healthy and Damaged Achilles Tendon Model: Histopathological and Biomechanical Experimental Study in Rats. Turk Patoloji Derg 2020; 36:39-47. [PMID: 31538652 PMCID: PMC10512677 DOI: 10.5146/tjpath.2019.01468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 09/01/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To show the effects of corticosteroids on inflammatory reactions in the injured Achilles tendon in rats. MATERIAL AND METHOD Thirty-two adult Wistar Albino rats were used in the study. The rats were divided into 4 groups. In the first group (Intact Saline), saline solution was injected to the intact Achilles tendon. In the second group (Intact Corticosteroid), corticosteroid was injected to the intact tendon. In the third group (Injured Saline), saline solution was injected to the injured Achilles tendon. In the fourth group (Injured Corticosteroid), corticosteroid was injected to the injured tendon. All groups were sacrificed on day 30 and Achilles tendons were taken and prepared for histological and biomechanical evaluation. RESULTS According to the biomechanical test; mean load-to-failure of the Intact Saline group was significantly lower than the Intact Corticosteroid (p=0.016), Injured Saline (p=0.001) and Injured Corticosteroid) (p=0.012) groups. According to the histopathological evaluation, tenocyte mean of the Intact Saline group was statistically lower than the Injured Saline and Injured Corticosteroid groups. Tenocyte mean of the Intact Corticosteroid group was statistically significantly lower than the Injured Saline and Injured Corticosteroid groups. The ground substance mean of the Intact Saline group was significantly lower than the Injured Saline and Injured Corticosteroid groups. The ground substance mean of the Intact Corticosteroid group was significantly lower than the Injured Saline and Injured Corticosteroid groups. There was no statistically significant difference between the groups in terms of calcification. CONCLUSION It has been found that there is biomechanical and histopathological significant benefit of intra-tendon corticosteroid administration in the experimentally generated Achilles tendon injury model.
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Affiliation(s)
- İlyas Arslan
- Department of Orthopedics and Traumatology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Istemi Yücel
- Department of Orthopedics and Traumatology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Turhan Beyza Öztürk
- Department of 2nd Grade Student, İstanbul Bahçeşehir University Faculty of Medicine, İstanbul, Turkey
| | - Nazım Karahan
- Department of Orthopedics and Traumatology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - M. Müfit Orak
- Department of Orthopedics and Traumatology, İstanbul Bahçeşehir University Faculty of Medicine, İstanbul, Turkey
| | - Ahmet Midi
- Department of Pathology, İstanbul Bahçeşehir University Faculty of Medicine, İstanbul, Turkey
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Dams OC, Reininga IHF, Zwerver J, Diercks RL, van den Akker-Scheek I. The Achilles tendon Total Rupture Score is a responsive primary outcome measure: an evaluation of the Dutch version including minimally important change. Knee Surg Sports Traumatol Arthrosc 2020; 28:3330-3338. [PMID: 32146524 PMCID: PMC7511458 DOI: 10.1007/s00167-020-05924-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/25/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Aim of this study was to evaluate the responsiveness of the Dutch version of the Achilles tendon Total Rupture Score (ATRS-NL). METHODS Patients (N = 47) completed the ATRS-NL at 3 and 6 months after Achilles tendon rupture (ATR). Additionally, they filled out the Euroqol-5D-5L (EQ-5D-5L) and Global Rating of Change Score (GRoC). Effect sizes (ES) and standardized response means (SRM) were calculated. The anchor-based method for determining the minimally important change (MIC) was used. GRoC and improvement on the items mobility and usual activities on the EQ-5D-5L served as external criteria. The scores on these anchors were used to categorize patients' physical functioning as improved or unchanged between 3 and 6 months after ATR. Receiver operating curve (ROC) analysis was performed, with the calculation of the area under the ROC curve (AUC) and the estimation of MIC values using the optimal cut-off points. RESULTS There was a large change (ES: 1.58) and good responsiveness (SRM: 1.19) of the ATRS-NL between 3 and 6 months after ATR. Using ROC analysis, the MIC values ranged from 13.5 to 28.5 for reporting improvement on EQ-5D-5L mobility and GRoC, respectively. The AUC of improvement on mobility and improvement on GRoC were > 0.70. CONCLUSION The ATRS-NL showed good responsiveness in ATR patients between 3 and 6 months after injury. Use of this questionnaire is recommended in clinical follow-up and longitudinal research of ATR patients. MIC values of 13.5 and 28.5 are recommended to consider ATR patients as improved and greatly improved between 3 and 6 months after ATR. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Olivier C. Dams
- Department of Orthopaedic Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Inge H. F. Reininga
- Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Johannes Zwerver
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands ,Sports Valley, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP Ede, The Netherlands
| | - Ronald L. Diercks
- Department of Orthopaedic Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Inge van den Akker-Scheek
- Department of Orthopaedic Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
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Touzopoulos P, Ververidis A, Giakas G, Drosos GI. Validation and cross-cultural adaptation of Greek version of Achilles tendon Total Rupture Score. Foot Ankle Surg 2019; 25:8-12. [PMID: 29409266 DOI: 10.1016/j.fas.2017.07.560] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 04/15/2017] [Accepted: 07/19/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND The purpose of this study was the translation, cross-cultural adaptation and validation of the Achilles Tendon Total Rupture Score (ATRS) in Greek population. METHODS The translation and cross-cultural adaptation of the original version of ATRS in Greek language was performed according to the methodology described by Beaton et al. Validation and test-retest reliability were evaluated in forty-six patients, treated surgically for acute Achilles tendon rupture. Validity was evaluated by correlation of total and all subscale scores of Greek version of Manchester Foot Pain and Disability Index (MFPDI). Test-retest reliability evaluated with interclass correlation coefficient and Crombach's α coefficient was used for internal consistency. RESULTS The internal consistency (α=0.96) and test-retest reliability (ICC=0.97) were excellent. There were no ceiling and floor effects during test-retest assessment. The Greek version of ATRS showed strong correlation with all subscales and overall score of MFPDI (pain subscale: R=-0.954, p<0.01, function subscale: R=-0.811, p<0.01, appearance subscale: R=-0.763, p<0.01, overall: R=-0.914, p<0.01). CONCLUSIONS Greek version of ATRS was successfully adapted in Greek population and it appears to be a valid and reliable instrument to evaluate outcomes in Greek speaking patients after Achilles tendon rupture. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Panagiotis Touzopoulos
- Department of Orthopaedics, University General Hospital of Alexandroupolis, Alexandroupolis, Greece.
| | - Athanasios Ververidis
- Department of Orthopaedics, Faculty of Medicine, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Giannis Giakas
- Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Georgios I Drosos
- Department of Orthopaedics, Faculty of Medicine, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
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Bąkowski P, Rubczak S, Wolff-Stefaniak M, Grygorowicz M, Piontek T. Reliability and validity of the Polish version of the Achilles tendon Total Rupture Score. Knee Surg Sports Traumatol Arthrosc 2018; 26:2074-2079. [PMID: 29094171 PMCID: PMC6061432 DOI: 10.1007/s00167-017-4764-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 10/23/2017] [Indexed: 11/12/2022]
Abstract
PURPOSE The aim of this study was to perform the translation and cross-cultural adaptation of the Achilles tendon Total Rupture Score (ATRS) into Polish version, and to evaluate its reliability and validity. METHODS The ATRS was translated into Polish language according to the Beaton recommendations. A total number of 71 patients previously treated surgically (from 2011 to 2015), due to the Achilles tendon rupture, were enrolled in this study. ATRS-Polish was performed twice within a period of 5-10 days. To evaluate test-retest reliability, intra-rater coefficient (ICC) was calculated. Construct validity was determined by the Spearman's rank coefficient correlation between the ATRS-Polish and a Polish version of EQ-5D-5L questionnaire. RESULTS Test-retest reliability was found to be excellent (ICC 0.9). The mean and standard deviation of the first and second assessment amounted 87.4 ± 14.0 and 88.4 ± 13.2, respectively. Construct validity analysis showed a strong correlation between the ATRS and the EQ-5D-5L score (r = - 0.69.) and moderate correlation between ATRS and actual comfort (r = 0.47). CONCLUSIONS AND PERSPECTIVES Polish version of the Achilles tendon Total Rupture Score was found to be reliable and valid. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- Paweł Bąkowski
- Orthopedic Department, Rehasport Clinic, Górecka 30, 60-201, Poznan, Poland.
| | - Szymon Rubczak
- Orthopedic Department, Rehasport Clinic, Górecka 30, 60-201, Poznan, Poland
| | | | | | - Tomasz Piontek
- Orthopedic Department, Rehasport Clinic, Górecka 30, 60-201, Poznan, Poland.,Department of Spine Disorders and Pediatric Orthopedics, University of Medical Sciences Poznań, Poznan, Poland
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Vosoughi AR, Roustaei N, Mahdaviazad H. American Orthopaedic Foot and Ankle Society ankle-hindfoot scale: A cross-cultural adaptation and validation study from Iran. Foot Ankle Surg 2018; 24:219-223. [PMID: 29409212 DOI: 10.1016/j.fas.2017.02.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 01/11/2017] [Accepted: 02/03/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND The use of valid and reliable outcome rating scales is essential for evaluating the result of different treatments and interventions. The purposes of this study were to translate and culturally adapt the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale (AOFAS-AHFS) into Persian languages and evaluate its psychometric properties. METHODS Forward-backward translation and cultural adaptation method were used to develop Persian version of AOFAS-AHFS. From March to July 2016, one hundred consecutive patients with ankle and hindfoot injuries were included. Internal consistency and reproducibility were evaluated using Cronbach's alpha, Spearman's rank correlation coefficient and Intraclass correlation coefficient (ICC) respectively. Construct validity reported which compare the outcome rating scale measurements with Short Form-36 (SF-36), also convergent and discriminant validity evaluated using Spearman's rank correlation coefficient. RESULTS Mean age (SD) of the patients was 41.95±13.45years. Cronbach's α coefficient, Spearman's rho and ICC values were 0.71, 0.89 and 0.90 respectively. Total score of AOFAS-AHFS and SF-36 domains has a correlation ranged between 0.17-0.55. Spearman's rank correlation coefficient of 0.4 was exceeded by all items with the exception of stability. The Spearman's rank correlation between each item in functional subscales with its own subscales was higher than the correlation between these items and other subscales. CONCLUSIONS Persian version of AOFAS-AHFS provides additional reliable and valid instrument which can be used to assess broad range of patients with foot and ankle disorders that speaking in Persian. However, it seems that the original version of AOFAS-AHFS needs some revisions.
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Affiliation(s)
- Amir Reza Vosoughi
- Bone and Joint Diseases Research Center, Department of Orthopedic Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Narges Roustaei
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamideh Mahdaviazad
- Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Cross-cultural adaptation and multi-centric validation of the Italian version of the Achilles tendon Total Rupture Score (ATRS). Knee Surg Sports Traumatol Arthrosc 2018; 26:854-861. [PMID: 27139231 DOI: 10.1007/s00167-016-4152-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 04/26/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE The purpose of this study was to translate the Achilles tendon Total Rupture Score (ATRS) into Italian and establish its cultural adaptiveness and validity. METHODS The original version of the ATRS was translated into Italian in accordance with the stages recommended by Guillemin. A web-based survey was developed to test the construct validity of the Italian ATRS. Eighty patients with an average age of 45.5 years (SD 11) were included in the study. The ATRS was completed twice at 5 days intervals for test-retest reliability. The intraclass correlation coefficient was used to calculate the test-retest reliability, and Cronbach's α coefficient was used for internal consistency. Validity was evaluated by external correlation (Spearman's rank correlation coefficient, r) of the ATRS with the Italian versions of the Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A), the 17-Italian Foot Function Index (17-FFI), the Lower Extremity Functional Scale (LEFS), and the Short-Form 36 (SF-36). RESULTS The internal consistency (α = 0.97) and the test-retest reliability (ICC = 0.96) were excellent. The correlation coefficient showed strong correlation of the Italian ATRS with the VISA-A and the LEFS (r = 0.72 and r = 0.70, respectively, p < 0.0001), a weak correlation with the 17-FFI (r = -0.30, p = 0.007), and high-to-moderate correlation with the physical functioning, bodily pain, physical role functioning, social functioning, role emotional, and vitality of the SF-36 (r = 0.75, r = 0.61, r = 0.52, r = 0.49, r = 0.40 and r = 0.34, respectively, p < 0.0001). CONCLUSION The Italian version of the ATRS is a valid instrumentation to assess the functional limitations of Italian patients after Achilles tendon rupture. LEVEL OF EVIDENCE III.
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Myhrvold SB, Sandnes Ø, Hoelsbrekken SE. Validity and reliability of the Norwegian translation of the Achilles tendon Total Rupture Score. Knee Surg Sports Traumatol Arthrosc 2018; 26:2045-2050. [PMID: 28823061 PMCID: PMC6061451 DOI: 10.1007/s00167-017-4689-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 08/16/2017] [Indexed: 11/18/2022]
Abstract
PURPOSE Patient reported outcome measures (PROMs) are increasingly being used in clinical research. The Achilles tendon Total Rupture Score (ATRS) is a PROM designed to assess outcomes in patients with ruptures of the Achilles tendon. The aim of this study was to develop a Norwegian adaption of the ATRS and evaluate its validity and reliability. METHODS The ATRS was translated into Norwegian in accordance with recommended guidelines. The study included 94 patients treated for Achilles tendon ruptures from January 2010 until February 2013, and the web-based questionnaires were administered twice. Reliability was assessed by Cronbach's alpha, the intraclass correlation coefficient (ICC) and minimal detectable change (MDC). Construct validity was evaluated by calculating the Spearman's correlation coefficient with the five subclasses of the Foot and Ankle Outcome Score (FAOS), the SF-36 subclass physical function and the SF-36 physical and mental summary scores. RESULTS Both internal consistency (Cronbach's alpha = 0.96) and test-retest reliability (ICC = 0.90) were excellent, and the MDC was 2.12 at the group level and 16.98 at the individual level. Construct validity was supported by Spearman's correlation coefficients above 0.7 with the SF-36 subclass physical function and the SF-36 physical summary score as well as the FAOS subclasses Sport/Rec and quality of life. There was no floor effect, and 6 patients (6.4%) achieved a maximum score of 100. CONCLUSIONS The Norwegian adaption of the ATRS demonstrates acceptable validity and reliability for use in the Norwegian population to assess clinical outcomes in patients with Achilles tendon ruptures.
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Affiliation(s)
| | - Øystein Sandnes
- Department of Orthopedics, Ringerike Hospital, 3511 Hønefoss, Norway
| | - Sigurd Erik Hoelsbrekken
- Department of Orthopedic and Rheumatic Surgery, Kongsvinger Hospital, P.O. Box 901, 2226 Kongsvinger, Norway
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Opdam KTM, Zwiers R, Wiegerinck JI, Kleipool AEB, Haverlag R, Goslings JC, van Dijk CN. Reliability and validation of the Dutch Achilles tendon Total Rupture Score. Knee Surg Sports Traumatol Arthrosc 2018; 26:862-868. [PMID: 27417101 PMCID: PMC5847201 DOI: 10.1007/s00167-016-4242-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 07/06/2016] [Indexed: 11/06/2022]
Abstract
PURPOSE Patient-reported outcome measures (PROMs) have become a cornerstone for the evaluation of the effectiveness of treatment. The Achilles tendon Total Rupture Score (ATRS) is a PROM for outcome and assessment of an Achilles tendon rupture. The aim of this study was to translate the ATRS to Dutch and evaluate its reliability and validity in the Dutch population. METHODS A forward-backward translation procedure was performed according to the guidelines of cross-cultural adaptation process. The Dutch ATRS was evaluated for reliability and validity in patients treated for a total Achilles tendon rupture from 1 January 2012 to 31 December 2014 in one teaching hospital and one academic hospital. Reliability was assessed by the intraclass correlation coefficients (ICC), Cronbach's alpha and minimal detectable change (MDC). We assessed construct validity by calculation of Spearman's rho correlation coefficient with domains of the Foot and Ankle Outcome Score (FAOS), Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A) and Numeric Rating Scale (NRS) for pain in rest and during running. RESULTS The Dutch ATRS had a good test-retest reliability (ICC = 0.852) and a high internal consistency (Cronbach's alpha = 0.96). MDC was 30.2 at individual level and 3.5 at group level. Construct validity was supported by 75 % of the hypothesized correlations. The Dutch ATRS had a strong correlation with NRS for pain during running (r = -0.746) and all the five subscales of the Dutch FAOS (r = 0.724-0.867). There was a moderate correlation with the VISA-A-NL (r = 0.691) and NRS for pain in rest (r = -0.580). CONCLUSION The Dutch ATRS shows an adequate reliability and validity and can be used in the Dutch population for measuring the outcome of treatment of a total Achilles tendon rupture and for research purposes. LEVEL OF EVIDENCE Diagnostic study, Level I.
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Affiliation(s)
- K. T. M. Opdam
- 0000000084992262grid.7177.6Department of Orthopaedic Surgery, Orthopaedic Research Center Amsterdam, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - R. Zwiers
- 0000000084992262grid.7177.6Department of Orthopaedic Surgery, Orthopaedic Research Center Amsterdam, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - J. I. Wiegerinck
- 0000000084992262grid.7177.6Department of Orthopaedic Surgery, Orthopaedic Research Center Amsterdam, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - A. E. B. Kleipool
- grid.440209.bDepartment of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, Oosterpark 9, 1091 AC Amsterdam, The Netherlands
| | - R. Haverlag
- grid.440209.bDepartment of Surgery, Onze Lieve Vrouwe Gasthuis, Oosterpark 9, 1091 AC Amsterdam, The Netherlands
| | - J. C. Goslings
- 0000000084992262grid.7177.6Trauma Unit, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - C. N. van Dijk
- 0000000084992262grid.7177.6Department of Orthopaedic Surgery, Orthopaedic Research Center Amsterdam, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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Transcultural adaptation and validation of the Chinese version of the intermittent and constant osteoarthritis pain (ICOAP) measure in patients with knee osteoarthritis. Osteoarthritis Cartilage 2017; 25:506-512. [PMID: 27914877 DOI: 10.1016/j.joca.2016.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 11/05/2016] [Accepted: 11/25/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study aimed to translate and adapt the intermittent and constant osteoarthritis pain (ICOAP) measure into the Chinese language (ICOAP-C), and to study its psychometric properties in patients with knee osteoarthritis (OA). DESIGN The ICOAP was translated and cognitively pretested following internationally recommended guidelines. The reliability, including the internal consistency and the test-retest reliability, was then evaluated in 108 outpatients with knee OA. The validity was assessed by comparing the ICOAP-C with the Western Ontario and McMaster Universities Osteoarthritis Index Pain Subscale (WOMAC-PS), the Knee Injury and Osteoarthritis Outcome Score Pain Short-Form (KOOS-PS), and pain on a visual analogue scale (VAS). Seventy-four patients undergoing total knee arthroplasty (TKA) participated in the evaluation of the responsiveness of the ICOAP-C over a 6-month period. RESULTS All participants completed the questionnaires, and no floor or ceiling effects were found. All ICOAP-C scales exhibited satisfactory internal consistency. The intraclass correlation coefficients (ICCs) were excellent, i.e., 0.932 for "total pain", 0.908 for "intermittent pain" and 0.892 for "constant pain". Regarding the convergent validity, the ICOAP-C scores exhibited strong correlations with the WOMAC-PS and moderate correlations with the KOOS-PS and the VAS. The responsiveness of the ICOAP-C at 6 months after TKA was good [standardized response mean (SRM) range: 0.94-1.20; effect size (ES) range: 1.41-1.71]. CONCLUSIONS The ICOAP-C exhibited good reliability, validity, and responsiveness. This scale is a reliable instrument for evaluating the pain experiences of patients with knee OA and is useful for outcome measurement in clinical research.
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Cui J, Jia Z, Zhi X, Li X, Zhai X, Cao L, Weng W, Zhang J, Wang L, Chen X, Su J. The chinese version of achilles tendon total rupture score: cross-cultural adaptation, reliability and validity. Health Qual Life Outcomes 2017; 15:2. [PMID: 28069003 PMCID: PMC5220618 DOI: 10.1186/s12955-016-0574-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 12/08/2016] [Indexed: 12/28/2022] Open
Abstract
Background The Achilles tendon Total Rupture Score (ATRS), which is originally developed in 2007 in Swedish, is the only patient-reported outcome measure (PROM) for specific outcome assessment of an Achilles tendon rupture.Purpose of this study is to translate and cross-culturally adapt Achilles tendon Total Rupture Score (ATRS) into simplified Chinese, and primarily evaluate the responsiveness, reliability and validity. Methods International recognized guideline which was designed by Beaton was followed to make the translation of ATRS from English into simplified Chinese version (CH-ATRS). A prospective cohort study was carried out for the cross-cultural adaptation. There were 112 participants included into the study. Psychometric properties including floor and ceiling effects, Cronbach’s alpha, intraclass correlation coefficient, effect size, standard response mean, and construct validity were tested. Results The mean scores of CH-ATRS are 57.42 ± 13.70. No sign of floor or ceiling effect was found of CH-ATRS. High level of internal consistency was supported by the value of Cronbach’s alpha (0.893). ICC (0.979, 95%CI: 0.984-0.993) was high to indicate the high test-retest reliability. Great responsive ness was proved with the high absolute value of ES and SRM (0.84 and 8.98, respectively). The total CH-ATRS score had very good correlation with physical function and body pain subscales of SF-36 (r = −0.758 and r = −0.694, respectively, p < 0.001), while poor correlation with vitality and role physical subscales of SF-36 (r = −0.033 and r = −0.025, respectively, p ≥ 0.05), which supported construct validity of CH-ATRS. Conclusion This Chinese version of Achilles tendon Total Rupture Score (CH-ATRS) can be used as a reliable and valid instrument for Achilles tendon rupture assessing in Chinese-speaking population. Level of evidence II Electronic supplementary material The online version of this article (doi:10.1186/s12955-016-0574-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jin Cui
- Graduate Management Unit, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China
| | - Zhenyu Jia
- Graduate Management Unit, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China
| | - Xin Zhi
- Graduate Management Unit, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China
| | - Xiaoqun Li
- Graduate Management Unit, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China
| | - Xiao Zhai
- Graduate Management Unit, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China
| | - Liehu Cao
- Department of Orthopedics, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China
| | - Weizong Weng
- Department of Orthopedics, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China
| | - Jun Zhang
- Department of Orthopedics, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China
| | - Lin Wang
- Department of Orthopedics, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China
| | - Xiao Chen
- Department of Orthopedics, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China.
| | - Jiacan Su
- Department of Orthopedics, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China.
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Yasuda T, Shima H, Mori K, Kizawa M, Neo M. Direct Repair of Chronic Achilles Tendon Ruptures Using Scar Tissue Located Between the Tendon Stumps. J Bone Joint Surg Am 2016; 98:1168-75. [PMID: 27440564 DOI: 10.2106/jbjs.15.00865] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Several surgical procedures for chronically ruptured Achilles tendons have been reported. Resection of the interposed scar tissue located between the tendon stumps and reconstruction using normal autologous tissue have been well described. We developed a direct repair procedure that uses scar tissue, which obviates the need to use normal autologous tissue. METHODS Thirty consecutive patients with Achilles tendon ruptures with a delay in diagnosis of >4 weeks underwent removal of a section of scar and healing tissue with direct primary suture of the ends of the tendon without the use of allograft or autograft. Patients were followed for a mean time of 33 months. Preoperative and postoperative clinical outcomes were measured with the Achilles Tendon Total Rupture Score (ATRS) and the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score. In addition, the patients underwent preoperative and postoperative functional measurements and magnetic resonance imaging. Lastly, we evaluated the histology of the interposed healing tissue. RESULTS The mean AOFAS scores were 82.8 points preoperatively and 98.1 points postoperatively. The mean postoperative ATRS was 92.0 points. At the time of the latest follow-up, none of the patients had experienced tendon reruptures or difficulties in walking or climbing stairs, and all except 2 patients could perform a single-limb heel rise. All athletes had returned to their pre-injury level of sports participation. Preoperative T2-weighted magnetic resonance imaging showed that 22 Achilles tendons were thickened with diffuse intratendinous high-signal alterations, and 8 Achilles tendons were thinned. Postoperative T2-weighted magnetic resonance imaging findings included fusiform-shaped tendon thickening and homogeneous low-signal alterations of the tendons in all patients. Histologically, the interposed scar tissue consisted of dense collagen fibers. CONCLUSIONS Shortening of the tissue between the 2 tendon ends that included healing scar and direct repair of healing tendon without allograft or autograft can be effective for treatment-delayed or neglected Achilles tendon rupture. LEVEL OF EVIDENCE Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Toshito Yasuda
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
| | - Hiroaki Shima
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
| | - Katsunori Mori
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
| | - Momoko Kizawa
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
| | - Masashi Neo
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
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Spennacchio P, Vascellari A, Cucchi D, Canata GL, Randelli P. Outcome evaluation after Achilles tendon ruptures. A review of the literature. JOINTS 2016; 4:52-61. [PMID: 27386448 DOI: 10.11138/jts/2016.4.1.052] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The optimal treatment and the best rehabilitation protocol after an acute Achilles tendon rupture (ATR) remain a matter of controversy in orthopaedic and sports medicine. The use of validated injury-specific outcome instruments is the only way to clarify these issues, in order to ensure that patients receive the best possible treatment. This article describes the most commonly reported outcome measures used to assess patients treated for ATR. On the basis of the available evidence, the Achilles tendon Total Rupture Score (ATRS) is the most appropriate outcome measure for evaluating the management of acute ATR.
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Ansari NN, Naghdi S, Hasanvand S, Fakhari Z, Kordi R, Nilsson-Helander K. Cross-cultural adaptation and validation of Persian Achilles tendon Total Rupture Score. Knee Surg Sports Traumatol Arthrosc 2016; 24:1372-80. [PMID: 26740087 DOI: 10.1007/s00167-015-3977-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 12/22/2015] [Indexed: 02/05/2023]
Abstract
PURPOSE To cross-culturally adapt the Achilles tendon Total Rupture Score (ATRS) to Persian language and to preliminary evaluate the reliability and validity of a Persian ATRS. METHODS A cross-sectional and prospective cohort study was conducted to translate and cross-culturally adapt the ATRS to Persian language (ATRS-Persian) following steps described in guidelines. Thirty patients with total Achilles tendon rupture and 30 healthy subjects participated in this study. Psychometric properties of floor/ceiling effects (responsiveness), internal consistency reliability, test-retest reliability, standard error of measurement (SEM), smallest detectable change (SDC), construct validity, and discriminant validity were tested. Factor analysis was performed to determine the ATRS-Persian structure. RESULTS There were no floor or ceiling effects that indicate the content and responsiveness of ATRS-Persian. Internal consistency was high (Cronbach's α 0.95). Item-total correlations exceeded acceptable standard of 0.3 for the all items (0.58-0.95). The test-retest reliability was excellent [(ICC)agreement 0.98]. SEM and SDC were 3.57 and 9.9, respectively. Construct validity was supported by a significant correlation between the ATRS-Persian total score and the Persian Foot and Ankle Outcome Score (PFAOS) total score and PFAOS subscales (r = 0.55-0.83). The ATRS-Persian significantly discriminated between patients and healthy subjects. Explanatory factor analysis revealed 1 component. CONCLUSION The ATRS was cross-culturally adapted to Persian and demonstrated to be a reliable and valid instrument to measure functional outcomes in Persian patients with Achilles tendon rupture. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Enghelab Ave, Pitch-e-shemiran, Tehran, 11489, Iran.
| | - Soofia Naghdi
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Enghelab Ave, Pitch-e-shemiran, Tehran, 11489, Iran
| | - Sahar Hasanvand
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Enghelab Ave, Pitch-e-shemiran, Tehran, 11489, Iran
| | - Zahra Fakhari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Enghelab Ave, Pitch-e-shemiran, Tehran, 11489, Iran
| | - Ramin Kordi
- Sports Medicine Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Katarina Nilsson-Helander
- Department of Orthopaedic, Sahlgrenska Academy, Gothenburg University, Kungsbacka Hospital Tölövägen 5, 434 40, Kungsbacka, Sweden
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