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Miyazaki K, Fujii M, Kawano S, Ueno M, Kitajima M, Sonohata M, Mawatari M. Functional Improvement and Patient Satisfaction Following Conversion of Fused Hip to Total Hip Arthroplasty. J Arthroplasty 2024; 39:2512-2519. [PMID: 39025276 DOI: 10.1016/j.arth.2024.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 07/01/2024] [Accepted: 07/08/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND This study aimed to determine the clinical outcomes, predictors of suboptimal functional improvement, and factors influencing patient satisfaction following conversion of a fused hip to total hip arthroplasty (THA). METHODS A retrospective analysis of clinical and radiographic data was performed on 83 patients (83 hips) who underwent fused hip conversion to THA. Implant survival and predictors of poor functional outcome (Harris hip score < 70) were analyzed. In addition, factors associated with patient dissatisfaction (visual analog scale < 25th percentile) were analyzed in 63 patients (63 hips) who completed a patient-reported outcome measures questionnaire. RESULTS The median Harris hip score improved from 55 (range, 18 to 77) to 78 (range, 36 to 100) at a mean follow-up of 10.2 ± 4.8 years (P < .001). Implant survival was 97.4% at 10 years and 91.3% at 20 years, with any revision as the endpoint. Multivariate analysis identified preoperative reliance on mobility aids as an independent predictor of poor functional outcome (P = .021). There were 48 of 63 patients (76%) satisfied (satisfaction visual analog scale ≥80) with the operated hip. Demographics and preoperative/postoperative clinical data did not differ between satisfied and unsatisfied patients. Among the patient-reported outcome measures, the Forgotten Joint Score-12 emerged as an independent discriminator of patient satisfaction. CONCLUSIONS Conversion of a fused hip to THA provides functional improvement, favorable implant survival, and high patient satisfaction. However, patients dependent on mobility aids may experience suboptimal functional recovery, underscoring the need for careful preoperative counseling and patient selection.
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Affiliation(s)
- Kensuke Miyazaki
- Faculty of Medicine, Department of Orthopaedic Surgery, Saga University, Saga, Japan
| | - Masanori Fujii
- Faculty of Medicine, Department of Orthopaedic Surgery, Saga University, Saga, Japan
| | - Shunsuke Kawano
- Faculty of Medicine, Research Center for Arthroplasty, Saga University, Saga, Japan
| | - Masaya Ueno
- Faculty of Medicine, Department of Orthopaedic Surgery, Saga University, Saga, Japan
| | - Masaru Kitajima
- Department of Orthopaedic Surgery, Shiroishi Kyoritsu Hospital, Saga, Japan
| | - Motoki Sonohata
- Department of Orthopaedic Surgery, JCHO Saga Central Hospital, Saga, Japan
| | - Masaaki Mawatari
- Faculty of Medicine, Department of Orthopaedic Surgery, Saga University, Saga, Japan
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Ikutomo H, Nakamura M, Okamura K, Togomori K, Nakagawa N, Masuhara K. Effects of lower limb vibration on hip pain and function after total hip arthroplasty: A randomized controlled trial. J Orthop Sci 2024:S0949-2658(24)00180-5. [PMID: 39227231 DOI: 10.1016/j.jos.2024.08.003] [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: 01/24/2024] [Revised: 06/25/2024] [Accepted: 08/13/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND A vibration roller is an effective tool for reducing muscle soreness and improving damaged muscle function. However, its efficacy in reducing hip pain and improving function after total hip arthroplasty is unclear. We investigated the effect of lower limb vibration using a vibration roller on postoperative hip pain and function after total hip arthroplasty in a randomized controlled clinical trial. METHODS Thirty patients scheduled for total hip arthroplasty were randomly assigned to vibration and control groups. The patients in the vibration group performed lower limb vibration using a vibration roller. The patients in the control group performed sham therapy using a hot pack. Patients performed both interventions for 10 min daily on postoperative days 1-7, in addition to regular physical therapy. Primary outcome was hip pain intensity as measured using a visual analog scale. Secondary outcomes were pain-pressure threshold and serum creatine kinase and C-reactive protein levels. We also assessed physical functions, including the Harris Hip Score, range of motion of the hip joint, muscle strength, gait velocity, and timed up-and-go test. The effects of the interventions on outcome measurements in the groups were compared using a split-plot design variance analysis. RESULTS After one week of the intervention and three weeks of follow-up, the vibration group showed statistically significant improvement in the exercise-induced hip pain, pain-pressure threshold of lateral thigh, and serum creatine kinase compared to the control group (p = 0.006, 0.003, and 0.012, respectively). No statistically significant differences were found between the groups regarding the physical functions. CONCLUSIONS Lower limb vibration using a vibration roller after total hip arthroplasty was an effective intervention to reduce exercise-induced hip pain and improve serum creatine kinase, but there was no synergistic effect on the physical functions.
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Affiliation(s)
- Hisashi Ikutomo
- Department of Rehabilitation, Masuhara Clinic, Osaka, Japan.
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Gökşen A, Çaylak R, Çekok FK, Kahraman T. Translation, cross-cultural adaptation, reliability, and convergent and known-group validity of the Turkish full version of the Hip Disability and Osteoarthritis Outcome Score in patients with hip osteoarthritis. Arch Rheumatol 2024; 39:180-193. [PMID: 38933727 PMCID: PMC11196225 DOI: 10.46497/archrheumatol.2024.10197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/31/2023] [Indexed: 06/28/2024] Open
Abstract
Objectives The study aimed to culturally adapt the full version of the Hip Disability and Osteoarthritis Outcome Score (HOOS) into Turkish and evaluate its reliability and validity. Patients and methods Patients with hip osteoarthritis were included in the methodological crosscultural adaptation study between May 2022 and December 2022. We translated and adapted the HOOS into a Turkish version and validated it in a cohort of native Turkish-speaking patients with hip osteoarthritis. The HOOS includes five subscales named symptoms, pain, activities of daily living (ADL), sport and recreation (Sport/Rec), and quality of life (QoL). The psychometric properties of the Turkish HOOS were assessed. The reliability was investigated using test-retest reliability (intraclass correlation coefficient; ICC) and internal consistency methods (Cronbach's alpha). The convergent validity of the Turkish HOOS was evaluated by testing the predefined hypotheses using the correlations with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the European Quality of Life Scale (EQ-5D-3L), a generic QoL scale. Results A total of 202 patients (131 females, 71 males; mean age: 55.2±9.7 years; range, 50 to 70 years) were recruited for the study. Cronbach's alpha values for each subscale of the HOOS were as follows: symptoms=0.76, pain=0.94, ADL=0.96, Sport/Rec=0.87, QoL=0.78, and total score=0.98, indicating it has high internal consistency. For all subscales and total score of the HOOS, the ICC values were between 0.77 and 0.86, indicating good to excellent test-retest reliability. All correlations between each subscale and total score of the Turkish HOOS, WOMAC, and EQ-5D-3L were moderate to strong. Therefore, 23 predefined hypotheses out of 24 were confirmed with a confirmation rate of 96%, indicating the Turkish version of the HOOS had adequate convergent validity. Conclusion This study shows that the Turkish version of the HOOS has a convergent and knowngroup validity, internal consistency, and test-retest reliability. It can be used to assess the patient's perception of their hip and associated difficulties, as well as their symptoms and functional limitations.
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Affiliation(s)
- Ayşenur Gökşen
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Tarsus University, Mersin, Türkiye
| | - Remzi Çaylak
- Acıbadem Adana Ortopedia Hospital, Adana, Türkiye
| | - Fatma Kübra Çekok
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Tarsus University, Mersin, Türkiye
| | - Turhan Kahraman
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom
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Tanaka S, Fujii M, Kawano S, Ueno M, Sonohata M, Kitajima M, Mawatari D, Mawatari M. Joint awareness following periacetabular osteotomy in patients with hip dysplasia. Bone Joint J 2023; 105-B:760-767. [PMID: 37399111 DOI: 10.1302/0301-620x.105b7.bjj-2022-1441.r1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
Aims The aims of this study were to validate the Forgotten Joint Score-12 (FJS-12) in the postoperative evaluation of periacetabular osteotomy (PAO), identify factors associated with joint awareness after PAO, and determine the FJS-12 threshold for patient-acceptable symptom state (PASS). Methods Data from 686 patients (882 hips) with hip dysplasia who underwent transposition osteotomy of the acetabulum, a type of PAO, between 1998 and 2019 were reviewed. After screening the study included 442 patients (582 hips; response rate, 78%). Patients who completed a study questionnaire consisting of the visual analogue scale (VAS) for pain and satisfaction, FJS-12, and Hip disability and Osteoarthritis Outcome Score (HOOS) were included. The ceiling effects, internal consistency, convergent validity, and PASS thresholds of FJS-12 were investigated. Results The median follow-up was 12 years (interquartile range 7 to 16). The ceiling effect of FJS-12 was 7.2%, the lowest of all the measures examined. FJS-12 correlated with all HOOS subscales (ρ = 0.72 to 0.77, p < 0.001) and pain and satisfaction-VAS (ρ = -0.63 and 0.56, p < 0.001), suggesting good convergent validity. Cronbach's α was 0.95 for the FJS-12, which indicated excellent internal consistency. The median FJS-12 score for preoperative Tönnis grade 0 hips (60 points) was higher than that for grade 1 (51 points) or 2 (46 points). When PASS was defined as pain-VAS < 21 and satisfaction-VAS ≥ 77, the FJS-12 threshold that maximized the sensitivity and specificity for detecting PASS was 50 points (area under the curve (AUC) = 0.85). Conclusion Our results suggest that FJS-12 is a valid and reliable assessment tool for patients undergoing PAO, and the threshold of 50 points may be useful to determine patient satisfaction following PAO in clinical settings. Further investigation of the factors influencing postoperative joint awareness may enable improved prediction of treatment efficacy and informed decision-making regarding the indication of PAO.
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Affiliation(s)
- Shiori Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Masanori Fujii
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Shunsuke Kawano
- Research Center for Arthroplasty, Faculty of Medicine, Saga University, Saga, Japan
| | - Masaya Ueno
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Motoki Sonohata
- Department of Orthopedic Surgery, JCHO Saga Central Hospital, Saga, Japan
| | - Masaru Kitajima
- Department of Orthopedic Surgery, Shiroishi Kyouritsu Hospital, Saga, Japan
| | - Daisuke Mawatari
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Masaaki Mawatari
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan
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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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Pain Sensitization and Neuropathic Pain-like Symptoms Associated with Effectiveness of Exercise Therapy in Patients with Hip and Knee Osteoarthritis. Pain Res Manag 2022; 2022:4323045. [PMID: 36071945 PMCID: PMC9444422 DOI: 10.1155/2022/4323045] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 07/21/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022]
Abstract
Pain sensitization and neuropathic pain-like symptoms are some of the common pain symptoms in patients with lower limbs, including hip and knee, osteoarthritis (HOA/KOA). Exercise therapy has been the first-line treatment; however, the effects differ for each patient. This prospective cohort study investigated the relationship between the effectiveness of exercise therapy and pretreatment characteristics (radiologic severity, pain sensitization, and neuropathic pain-like symptoms) of patients with HOA/KOA. We assessed the pain intensity using a numerical rating scale (NRS) before and after 12 weeks of exercise therapy in patients with HOA/KOA (n = 101). Before treatment, the Kellgren–Lawrence (K-L) grade; minimum joint space width (mJSW); pressure pain threshold (PPT) and temporal summation of pain (TSP) at the affected joint, tibia, and forearm; Central Sensitization Inventory-9; and painDETECT questionnaire (PDQ) were assessed. Cluster analysis was based on the pretreatment NRS and change in NRS with exercise therapy to identify the subgroups of pain reduction. The pretreatment characteristics of each cluster were compared. According to the results of the cluster analyses, patients in cluster 1 had severe pain that did not improve after exercise therapy, patients in cluster 2 had severe pain that improved, and those in cluster 3 had mild pain that improved. The patients in cluster 1 exhibited lower PPT at all measurement sites, higher TSP at the affected joint, and higher PDQ scores than those in other clusters. There was no difference in the K-L grade and mJSW among the clusters. The subgroup with severe pain and pain sensitization or neuropathic pain-like symptoms at pretreatment, even with mild joint deformity, may have difficulty in achieving improvement in pain after 12 weeks of exercise therapy. These findings could be useful for prognosis prediction and for planning exercise therapy and combining with other treatment.
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Hattori T, Shimo K, Niwa Y, Tokiwa Y, Matsubara T. Association of Chronic Pain with Radiologic Severity and Central Sensitization in Hip Osteoarthritis Patients. J Pain Res 2021; 14:1153-1160. [PMID: 33911897 PMCID: PMC8075310 DOI: 10.2147/jpr.s296273] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/17/2021] [Indexed: 12/27/2022] Open
Abstract
Purpose Pain and joint deformity are the most common symptoms of hip osteoarthritis (OA). However, no significant association between pain and severity of radiographic lesions has been reported. Recently, central sensitization has been suggested as an underlying mechanism of pain in OA. We investigated the involvement of radiologic severity or central sensitization in the clinical manifestation of hip OA with various degrees of joint deformity. Patients and Methods We included 39 patients with hip OA and divided them into two groups according to the severity of the hip pain: strong/severe (numerical rating scale, NRS≥6) and mild/moderate (NRS<6). We assessed the radiologic severity of OA using the Kellgren-Lawrence (K-L) scale and minimum joint space width (mJSW). We conducted quantitative sensory testing (QST) that included pressure pain threshold (PPT) and temporal summation of pain (TSP) at hip, tibialis anterior (leg), and extensor carpi radialis longus (arm) on the affected side. We examined the difference of radiologic assessment and QST results between each group and the correlation of the NRS with the radiologic assessment and QST results. Results There was no significant difference in the K-L scale and mJSW between patients with strong/severe and mild/moderate joint pain. Strong/severe pain patients demonstrated a lower PPT at all measurement sites and higher TSP at the hip and leg than the mild/moderate pain patients. In addition, NRS was significantly negatively correlated with PPT and positively correlated with TSP at all measurement sites, but not with the K-L scale and mJSW. Conclusion We reported no significant difference in radiologic severity between patients with strong/severe and mild/moderate joint pain. By contrast, we found a significant difference in central sensitization represented by QST between strong/severe and mild/moderate joint pain groups. These results suggest that central sensitization may be involved in the joint pain of patients with hip OA who complain of severe pain despite less severe joint deformity.
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Affiliation(s)
- Takafumi Hattori
- Faculty of Rehabilitation, Kobe Gakuin University Graduate School, Kobe, Hyogo, Japan.,Department of Rehabilitation, Maehara Orthopedics Rehabilitation Clinic, Obu, Aichi, Japan
| | - Kazuhiro Shimo
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe, Hyogo, Japan
| | - Yuto Niwa
- Faculty of Rehabilitation, Kobe Gakuin University Graduate School, Kobe, Hyogo, Japan
| | - Yuji Tokiwa
- Faculty of Rehabilitation, Kobe Gakuin University Graduate School, Kobe, Hyogo, Japan
| | - Takako Matsubara
- Faculty of Rehabilitation, Kobe Gakuin University Graduate School, Kobe, Hyogo, Japan.,Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe, Hyogo, Japan
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Gojło MK, Paradowski PT. Polish adaptation and validation of the hip disability and osteoarthritis outcome score (HOOS) in osteoarthritis patients undergoing total hip replacement. Health Qual Life Outcomes 2020; 18:135. [PMID: 32398020 PMCID: PMC7216355 DOI: 10.1186/s12955-020-01390-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 05/03/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The Hip disability and Osteoarthritis Outcome Score (HOOS) is a frequently used patient-reported outcome measure (PROM) for assessment of hip disorders and treatment effects following hip surgery. The objective of the study was to translate and adapt the Hip disability and Osteoarthritis Outcome Score (HOOS) into Polish and to investigate the psychometric properties of the HOOS in patients with osteoarthritis undergoing total hip replacement (THR). MATERIALS AND METHODS The Polish version of the HOOS was developed according to current guidelines. Patients completed the HOOS, Short Form 36 Health Survey (SF-36), the visual analogue scale (VAS) for pain and the global perceived effect (GPE) scale. Psychometric properties including interpretability (floor/ceiling effects), internal consistency (Cronbach's alpha), test-retest reliability (intra-class correlation coefficient, ICC), convergent construct validity (a priori hypothesized Spearman's correlations between the HOOS subscales, the generic SF-36 measure and the VAS for pain) and responsiveness (effect size, association between the HOOS and GPE scores) were analyzed. RESULTS The study included 157 patients (mean age 66.8 years, 54% women). Floor effects were found prior to THR for the HOOS subscales Sports and Recreation and Quality of Life. The Cronbach's alpha was over 0.7 for all subscales indicating satisfactory internal consistency. The test-retest reliability was good for the HOOS subscale Pain (0.82) and excellent for all other subscales with ICCs ranging from 0.91 to 0.96. The minimal detectable change ranged from 12.0 to 26.2 on an individual level and from 1.4 to 3.0 on a group level. Seven out of eight a priori hypotheses were confirmed indicating good construct validity. Responsiveness was high since the expected pattern of effect sizes in all subscales was found. CONCLUSIONS The Polish version of the HOOS demonstrated good reliability, validity and responsiveness for use in patient groups having THR.
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Affiliation(s)
- Marek K Gojło
- Department of Orthopaedics and Traumatology, Ministry of Interior and Administration Hospital, Warmia and Mazury Oncology Centre, Olsztyn, Poland
| | - Przemysław T Paradowski
- Division of Orthopaedics, Department of Surgical and Perioperative Sciences, Sunderby Research Unit, Umeå University, Umeå, Sweden. .,Department of Orthopaedics and Traumatology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University in Toruń, Jan Biziel University Hospital, Bydgoszcz, Poland. .,Clinical Epidemiology Unit, Orthopaedics, Department of Clinical Sciences, Lund University, Lund, Sweden.
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Translation, Cross-Cultural Adaptation, and Psychometric Properties of the Polish Version of the Hip Disability and Osteoarthritis Outcome Score (HOOS). ACTA ACUST UNITED AC 2019; 55:medicina55100614. [PMID: 31547119 PMCID: PMC6843159 DOI: 10.3390/medicina55100614] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/11/2019] [Accepted: 09/16/2019] [Indexed: 11/16/2022]
Abstract
Background and Objectives: This study aimed to translate the Hip disability and Osteoarthritis Outcome Score (HOOS) into the Polish language, to determine its validity and reliability, and to assess its main psychometric properties. Materials and Methods: A total of 332 hip osteoarthritis (OA) subjects were recruited to the study group and 90 healthy subjects to the control group. The study consisted of the HOOS translation and the assessment of the discriminative power, internal consistency, and the potential floor and ceiling effects followed by the determination of the construct validity and test-retest reliability. The analysis was performed using Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and SF-36 questionnaires. Results: The translation process consisted of forward translation, reconciliation, backward translation, review, harmonization, and proofreading. The hip OA patients reported a reduced HOOS score when compared to the control subjects. The discriminant validity of the questionnaire was confirmed. A Cronbach’s alpha of 0.97 was found, indicating a high internal consistency. The HOOS showed a significant correlation with the SF-36 and WOMAC, which ranged from r = −0.93, p-value < 0.05 for WOMAC total score to r = 0.92, and p-value < 0.05 for WOMAC daily living. No floor or ceiling effects were found. A very high intraclass correlation coefficient (ICC) was found (0.93–0.97) for the total score and the individual domains of the HOOS. Conclusions: The Polish HOOS is valid and reliable for evaluating the outcomes of hip OA patients in Poland. This questionnaire may be used with confidence for clinical and research purposes.
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Gandek B, Roos EM, Franklin PD, Ware JE. Item selection for 12-item short forms of the Knee injury and Osteoarthritis Outcome Score (KOOS-12) and Hip disability and Osteoarthritis Outcome Score (HOOS-12). Osteoarthritis Cartilage 2019; 27:746-753. [PMID: 30593867 DOI: 10.1016/j.joca.2018.11.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 11/16/2018] [Accepted: 11/27/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To develop 12-item short forms (KOOS-12, HOOS-12) of the 42-item Knee injury and Osteoarthritis Outcome Score (KOOS) and 40-item Hip disability and Osteoarthritis Outcome Score (HOOS) that represent the full-length instruments sufficiently to provide joint-specific pain, function and quality of life (QOL) domain and summary joint impact scores. This paper describes KOOS-12 and HOOS-12 item selection. Subsequent papers will examine KOOS-12 and HOOS-12 reliability, validity and responsiveness. DESIGN Items were selected based on qualitative information from patients, clinicians and KOOS/HOOS translators and analysis of data from 1,395 knee osteoarthritis (OA) and 1,281 hip OA patients from the FORCE-TJR cohort who completed KOOS or HOOS before and after total joint replacement (TJR). Item response theory models and computerized adaptive test (CAT) simulations were used to identify items that best measured patients' levels of pain and function pre- and post-TJR. KOOS-12/HOOS-12 items were selected based on content, coverage of a wide measurement range, high item information, item usage in CAT simulations, scale-level properties (reliability, validity, responsiveness), and qualitative information. RESULTS KOOS-12 and HOOS-12 each included a pain frequency item and three items measuring pain during increasingly difficult activities (sitting/lying, walking, up/down stairs); function items about standing, rising from sitting, getting in/out of a car, and twisting/pivoting (KOOS-12) or walking on an uneven surface (HOOS-12); and the original 4-item QOL scale. CONCLUSIONS This study demonstrated the benefits of examining patient-reported outcome measures using modern psychometric methods, to create short forms with diverse content that provide domain-specific and summary joint impact scores.
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Affiliation(s)
- B Gandek
- University of Massachusetts Medical School, Worcester, MA, USA; John Ware Research Group, Watertown, MA, USA.
| | - E M Roos
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
| | - P D Franklin
- University of Massachusetts Medical School, Worcester, MA, USA.
| | - J E Ware
- University of Massachusetts Medical School, Worcester, MA, USA; John Ware Research Group, Watertown, MA, USA.
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Hip complaints differ across age and sex: a population-based reference data for the Hip disability and Osteoarthritis Outcome Score (HOOS). Health Qual Life Outcomes 2018; 16:200. [PMID: 30309371 PMCID: PMC6182801 DOI: 10.1186/s12955-018-1022-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 09/18/2018] [Indexed: 12/04/2022] Open
Abstract
Background The Hip disability and Osteoarthritis Outcome Score (HOOS) is a self-administered hip-specific questionnaire intended to evaluate symptoms and functional limitations, and it is commonly used to evaluate interventions in individuals with hip dysfunction or hip osteoarthritis. The HOOS consists of 43 questions in five subscales: Pain, Symptoms, Function in daily living, Function in sport and recreation and Hip-Related Quality of Life. This study aimed to establish population-based reference values for the HOOS and to describe the variation of hip-related symptoms in an adult population. Methods The HOOS questionnaire was mailed to 840 individuals aged 18–84 years randomly retrieved from a national population record for the Skåne region of Southern Sweden. Results The overall response rate was 67%. Older women and men consistently reported more hip-related complaints than those younger. There were significant differences between the oldest and the youngest age groups in all five subscales in women and men. Conclusions Hip-related pain, symptoms, activity of daily life and quality of life varied with age and sex in this population-based cohort. Our findings show the importance of using age- and sex-matched reference values for evaluation of outcomes after interventions due to hip-related problems.
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12
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Cross-cultural adaptation and validation of the Italian version of the Hip disability and Osteoarthritis Outcome Score (HOOS). Health Qual Life Outcomes 2018; 16:115. [PMID: 29866107 PMCID: PMC5987663 DOI: 10.1186/s12955-018-0935-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 05/16/2018] [Indexed: 11/13/2022] Open
Abstract
Objective To create a translated version of the HOOS to fit the Italian population and to test its psychometric properties and validity in hip osteoarthritis (OA) patients undergoing total hip arthroplasty (THA). Design The HOOS Italian version was developed according to published international guidelines that include preparation, forward translation and reconciliation, backward translation, review and harmonization, and proof reading. The Italian HOOS was administered to 145 patients (mean age 65.7 ± 11.6 years, 34–89, 58.6% women) undergoing THA. The following psychometric properties were evaluated: internal consistency (Cronbach’s alpha); test-retest reliability (Pearson’s r and intra-class correlation coefficient, ICC); convergent validity (Spearman’s rho between HOOS and SF-36); responsiveness (comparison of pre/post-THA scores, Wilcoxon signed rank test). Interpretability (floor and ceiling effects, skewness and kurtosis indexes) and acceptability (time to compiling, missing answers, and autonomy in compilation) were also evaluated. Results Translation and transcultural adaptation were conducted in accordance with the international recommendation. The translation was deemed understandable and appropriate as to the transcultural adaptation. None of the patients reported to have met any difficulties in reading and understanding the HOOS items. Internal consistency and test-retest reliability were good for each HOOS subscale (Cronbach’s alpha ≥0.7, Pearson’s r and ICC > 0.80). Convergent validity showed the highest correlations (Spearman’s rho > 0.5) between HOOS and SF-36 subscales relating to similar dimensions. As to responsiveness, all HOOS subscales scores improved significantly after THA (p < 0.01). Interpretability was acceptable despite ceiling effect in post-THA assessment. Acceptability was good: HOOS resulted easy and quick to fill out (12 min on average). Conclusions The HOOS was successfully cross-culturally adapted into Italian. The Italian HOOS showed good psychometric properties therefore it can be useful to assess outcomes in OA patients after THA. This study provided a basis for its use within the Italian Arthroplasty Registry and for future clinical trials. Electronic supplementary material The online version of this article (10.1186/s12955-018-0935-6) contains supplementary material, which is available to authorized users.
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Mousavian A, Kachooie AR, Birjandinejad A, Khoshsaligheh M, Ebrahimzadeh MH. Translation and Cross-cultural Adaptation of the Hip Disability and Osteoarthritis Score into Persian Language: Reassessment of Validity and Reliability. Int J Prev Med 2018; 9:23. [PMID: 29619147 PMCID: PMC5869956 DOI: 10.4103/ijpvm.ijpvm_359_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 09/06/2017] [Indexed: 12/05/2022] Open
Abstract
Background: This study aimed Persian translation and validation of the hip disability and osteoarthritis outcome score (HOOS) questionnaire. Methods: The study was carried out in two phases. First, we translated the HOOS according to acceptable guidelines. We assessed HOOS content convergent validity on 203 hip osteoarthritis patients using SF-36. Internal consistency was tested using Cronbach's alpha coefficient if each item removed and intraclass correlation coefficient (ICC) for the assessment of test-retest reproducibility. Results: Patients had mean (standard deviation) age of 39 (17). Test-retest ICC in whole was 0.95 (P = 0.014) showing excellent reliability. ICC was 0.92 for the “pain” subscale (P = 0.02), 0.81 for the “symptom” subscale (P = 0.002), 0.81 for the “function of daily living (FDL)” (P = 0.022), 0.88 for the “function of sports and recreational activities” (P = 0.006), but it was 0.62 (P = 0.1) for the “quality of life (QOL).” Cronbach's alpha was 0.92, 0.73, 0.97, 0.86, 0.80, and 0.80 for the pain, symptom, FDL, function of sports, QOL, and stiffness, respectively, showing good to excellent internal consistancy. Having SF-36 for the assessment of convergent validity, there was a strong correlation between total HOOS score and the physical component summary domain of SF-36 (r = 0.64, P = 0.0001), whereas the t correlation with the mental component summary domain was weak (r = 0.16, P = 0.04). Conclusions: The Persian version of the HOOS questionnaire is a valid (regarding physical not mental aspects) and reliable assessment tool in patients with hip osteoarthritis.
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Affiliation(s)
- Alireza Mousavian
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Reza Kachooie
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Birjandinejad
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masood Khoshsaligheh
- Department of English Language and Literature, Ferdowsi University of Mashhad, Mashhad, Iran
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Gagnier JJ, Huang H, Mullins M, Marinac-Dabić D, Ghambaryan A, Eloff B, Mirza F, Bayona M. Measurement Properties of Patient-Reported Outcome Measures Used in Patients Undergoing Total Hip Arthroplasty. JBJS Rev 2018; 6:e2. [DOI: 10.2106/jbjs.rvw.17.00038] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Arbab D, van Ochten JHM, Schnurr C, Bouillon B, König D. Assessment of reliability, validity, responsiveness and minimally important change of the German Hip dysfunction and osteoarthritis outcome score (HOOS) in patients with osteoarthritis of the hip. Rheumatol Int 2017; 37:2005-2011. [PMID: 28983666 DOI: 10.1007/s00296-017-3834-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 09/23/2017] [Indexed: 11/29/2022]
Abstract
Patient-reported outcome measures are a critical tool in evaluating the efficacy of orthopedic procedures. The intention of this study was to evaluate reliability, validity, responsiveness and minimally important change of the German version of the Hip dysfunction and osteoarthritis outcome score (HOOS). The German HOOS was investigated in 251 consecutive patients before and 6 months after total hip arthroplasty. All patients completed HOOS, Oxford-Hip Score, Short-Form (SF-36) and numeric scales for pain and disability. Test-retest reliability, internal consistency, floor and ceiling effects, construct validity and minimal important change were analyzed. The German HOOS demonstrated excellent test-retest reliability with intraclass correlation coefficient values > 0.7. Cronbach´s alpha values demonstrated strong internal consistency. As hypothesized, HOOS subscales strongly correlated with corresponding OHS and SF-36 domains. All subscales showed excellent (effect size/standardized response means > 0.8) responsiveness between preoperative assessment and postoperative follow-up. The HOOS and all subdomains showed higher changes than the minimal detectable change which indicates true changes. The German version of the HOOS demonstrated good psychometric properties. It proved to be valid, reliable and responsive to the changes instrument for use in patients with hip osteoarthritis undergoing total hip replacement.
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Affiliation(s)
- Dariusch Arbab
- Department of Orthopedic Surgery, Klinikum Dortmund, Member Faculty of Health Witten/Herdecke University, Beurhausstraße 40, 44137, Dortmund, Germany.
| | - Johannes H M van Ochten
- Department of Orthopedics and Traumatology, Medizinisches Zentrum StädteRegion Aachen, Mauerfeldchen 25, 52146, Würselen, Germany
| | - Christoph Schnurr
- Department of Orthopedic Surgery, St. Vinzenz Krankenhaus, Schlossstraße 85, 40447, Düsseldorf, Germany
| | - Bertil Bouillon
- Department of Traumatology and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University of Witten/Herdecke, Ostmerheimer Str. 200, 51109, Cologne, Germany
| | - Dietmar König
- LVR Clinics of Orthopedic Surgery, Horionstraße 2, 41479, Viersen, Germany
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Cross-cultural adaptation and validation of the reliability of the Thai version of the Hip disability and Osteoarthritis Outcome Score (HOOS). Rheumatol Int 2016; 36:1455-8. [DOI: 10.1007/s00296-016-3505-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 05/25/2016] [Indexed: 10/21/2022]
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Lee S, Nardo L, Kumar D, Wyatt CR, Souza RB, Lynch J, McCulloch CE, Majumdar S, Lane NE, Link TM. Scoring hip osteoarthritis with MRI (SHOMRI): A whole joint osteoarthritis evaluation system. J Magn Reson Imaging 2015; 41:1549-57. [PMID: 25139720 PMCID: PMC4336224 DOI: 10.1002/jmri.24722] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 07/22/2014] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND To develop a semi-quantitative MR-based hip osteoarthritis (OA) evaluation system (Scoring hip osteoarthritis with MRI, SHOMRI), and to test its reproducibility and face validity. METHODS The study involved 98 subjects with informed consent. Three-Tesla MR imaging of hip was performed in three planes with intermediate-weighted fat saturated FSE sequences. Two radiologists assessed cartilage loss, bone marrow edema pattern, subchondral cyst in 10 subregions, and assessed labrum in 4 subregions. In addition, presence or absence of ligamentum teres integrity, paralabral cysts, intra-articular body, and effusion in the hip joint were analyzed using the SHOMRI system. The reproducibility was assessed with intra-class correlation coefficient (ICC), Cohen's Kappa values and percent agreement. SHOMRI scores were correlated with radiographic Kellgren-Lawrence (KL) and OARSI atlas gradings, and clinical parameters, the hip osteoarthritis outcome score (HOOS) and hip range of motion (ROM), using Spearman's rank correlation and ordinal logistic regression. RESULTS ICC values were in the excellent range, 0.91 to 0.97. Cohen's Kappa values and percent agreement ranged from 0.55 to 0.79 and 66 to 99%, respectively. SHOMRI demonstrated significant correlations with KL and OARSI gradings as well as with clinical parameters, HOOS and ROM (P < 0.05). Among the SHOMRI features, subchondral cyst and bone marrow edema pattern showed the highest correlation with HOOS and ROM. CONCLUSION SHOMRI demonstrated moderate to excellent reproducibility and significant correlation with radiographic gradings and clinical parameters.
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Affiliation(s)
- Sonia Lee
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, 185 Berry St. Suite 350 San Francisco, CA 94017 USA
| | - Lorenzo Nardo
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, 185 Berry St. Suite 350 San Francisco, CA 94017 USA
| | - Deepak Kumar
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, 185 Berry St. Suite 350 San Francisco, CA 94017 USA
| | - Cory R. Wyatt
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, 185 Berry St. Suite 350 San Francisco, CA 94017 USA
| | - Richard B. Souza
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, 185 Berry St. Suite 350 San Francisco, CA 94017 USA
| | - John Lynch
- Department of Epidemiology & Biostatistics, University of California San Francisco
| | - Charles E. McCulloch
- Department of Epidemiology & Biostatistics, University of California San Francisco
| | - Sharmila Majumdar
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, 185 Berry St. Suite 350 San Francisco, CA 94017 USA
| | - Nancy E. Lane
- Department of Medicine, University of California at Davis Medical School, Sacramento, CA
| | - Thomas M. Link
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, 185 Berry St. Suite 350 San Francisco, CA 94017 USA
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