Translation, cross-cultural adaptation and validation of the Slovenian version of Harris Hip Score

Translation, Cross-Cultural Adaptation, and Validation of the Persian Version of the Harris Hip Score

Background

The Harris hip score (HHS), a self-administered questionnaire, is widely used to evaluate hip pathology affecting health-related quality of life and physical function. This study's purpose was HHS translation to Persian (HHS-Pr) and validation in patients with different hip pathologies.

Methods

Translation and cultural adaptation followed existing guidelines. Hip pathology patients (n = 151) completed the HHS, 12-Item Health Survey, and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Criterion validity was determined from comparisons between the HHS measures and the different corresponding WOMAC domains. Internal consistency used Cronbach's alpha (α), content validity the "content validity index," and floor/ceiling effect the end-range 15%. Test-retest reliability used the intraclass correlation coefficient (subsample n = 30) at 3-7 days that compared baseline with a repeated measure. Measurement precision and change sensitivity used longitudinal assessment (subgroup n = 30) from the standard error of the measurement and minimal detectable change.

Results

Cross-cultural adaptation required minor wording changes. The mean HHS-Pr was 57.77 ± 19.69. Criterion validity was significant with the WOMAC (r = -0.76) and 12-Item Health Survey Physical Component Summary (r = 0.47). Internal consistency was high before (α = 0.75) and after standardization (α = 0.86). Content validity was satisfactory (content validity index = 0.88). No floor/ceiling effects were found. Test-retest reliability (intraclass correlation coefficient = 0.85) was excellent, as was standard error of the measurement (raw score = 5.8) and minimal detectable change (raw score = 11.4).

Conclusions

The HHS-Pr demonstrated adequate validity, reliability, and sensitivity to change. These psychometric properties sufficiently measure functional status in patients with hip pathologies in a Persian-speaking population.

[Translated article] Validation of the Spanish version of the modified Harris score

BACKGROUND AND OBJECTIVES

Modified Harris Hip Score (HHS) is one of the most used scales in the assessment of patients with hip pathology. Although a Spanish cross-cultural adaptation has been recently published, there are many studies supporting its validity yet. Therefore, the aim of this study is to validate the newly adapted Spanish version of the HHS (ES-EHM), comparing it with the WOMAC scale.

MATERIALS AND METHODS

The ES-EHM scale was applied to 100 patients who underwent a total hip replacement, in three different situations: (1) prior to surgery (pre-surgical ES-EHM), (2) after surgery, with at least 2 years of follow up (after surgery ES-EHM), and (3) 6 months after the postsurgical registration (final ES-EHM). WOMAC questionnaire was also applied once. We analysed data of scale main score, pain score, function-related score as well as the mean of pre-surgical, postsurgical and final postsurgical ES-EHM scale, in both the ES-EHM and the WOMAC scales. Parameters of reliability, validity and sensitivity to change were obtained.

RESULTS

Clinically relevant improvement was observed (46.55 points) when comparing pre-surgical and post-surgical ES-EHM scores. However, no differences between postsurgical and final ES-EHM were detected. Even so, strong correlation was obtained between the following: (1) postsurgical ES-EHM and final ES-EHM scores, (2) ES-EHM and WOMAC scores, and (3) pain and function-related parameters of ES-EHM and WOMAC scores. Standardised response mean (SRM) was 2.99, test-retest reliability expressed by the intraclass correlation coefficient was 0.90 and Cronbach index 0.95.

CONCLUSIONS

The Spanish cross-cultural adaptation of the EHM scale shows to be reliable, valid and sensitive to change. Thus, the Spanish medical staff will be able to apply the ES-EHM scale with good scientific support.

Validation of the Spanish version of the modified Harris score

BACKGROUND AND OBJECTIVES

Modified Harris Hip Score (HHS) is one of the most used scales in the assessment of patients with hip pathology. Although a Spanish cross-cultural adaptation has been recently published, there are many studies supporting its validity yet. Therefore, the aim of this study is to validate the newly adapted Spanish version of the HHS (ES-EHM), comparing it with the WOMAC scale.

MATERIALS AND METHODS

The ES-EHM scale was applied to 100 patients who underwent a total hip replacement, in three different situations: (1) prior to surgery (pre-surgical ES-EHM), (2) after surgery, with at least 2 years of follow up (after surgery ES-EHM), and (3) 6 months after the postsurgical registration (final ES-EHM). WOMAC questionnaire was also applied once. We analyzed data of scale main score, pain score, function-related score as well as the mean of pre-surgical, postsurgical and final postsurgical ES-EHM scale, in both the ES-EHM and the WOMAC scales. Parameters of reliability, validity and sensitivity to change were obtained.

RESULTS

Clinically relevant improvement was observed (46.55 points) when comparing pre-surgical and post-surgical ES-EHM scores. However, no differences between postsurgical and final ES-EHM were detected. Even so, strong correlation was obtained between the following: (1) postsurgical ES-EHM and final ES-EHM scores, (2) ES-EHM and WOMAC scores, and (3) pain and function-related parameters of ES-EHM and WOMAC scores. Standardized response mean (SRM) was 2.99, test-retest reliability expressed by the intraclass correlation coefficient was 0.90 and Cronbach index 0.95.

CONCLUSIONS

The Spanish cross-cultural adaptation of the EHM scale shows to be reliable, valid and sensitive to change. Thus, the Spanish medical staff will be able to apply the ES-EHM scale with good scientific support.

Effects of device-performed and manual hip traction and vibration therapy in older adults with symptomatic hip osteoarthritis: A randomized single-blind controlled trial

BACKGROUND

Traction-and-vibration-therapy (TVT) relieves pain in participants with hip osteoarthritis. Hip TVT is usually performed manually by the physiotherapist.

OBJECTIVE

A medical device was developed to perform hip-TVT in order to investigate effects on hip disability, pain intensity, recovery of balance and functional mobility in older adults with hip osteoarthritis and also to reduce physiotherapists' workload and help standardize treatment of hip TVT.

METHODS

In a block-randomized 3-month controlled trial involving 28 older adult participants with symptomatic primary hip osteoarthritis (SPHOA), one group (n= 10) received device-performed TVT, one (n= 10) manual TVT, and one (n= 8) sham/placebo therapy. Hip disability (Harris Hip Score), pain intensity (visual-analog-scale), recovery of balance and gait (Functional Gait Assessment) and functional mobility (Timed-Up-and-Go-test) were assessed at baseline, after 3 weeks without intervention, and after 3-month intervention.

RESULTS

The Device TVT and Manual TVT groups exhibited superior outcomes compared to the Placebo group in terms of hip disability (p= 0.005 and p< 0.001, respectively), pain intensity (p= 0.002 and p< 0.001, respectively), and functional mobility (TUG) (p= 0.012 and p= 0.011, respectively). Furthermore, the recovery of balance and gait (FGA) showed a significant improvement in the Device TVT group when compared to the Placebo group (p= 0.043). The effect sizes ranged from 0.17 to 0.51, indicating moderate to large effects.

CONCLUSION

Device-performed-TVT is comparable to manual hip-TVT for reducing pain and improving mobility in older adults with SPHOA, and may be beneficial in terms of reducing physiotherapists' workload and better therapy standardization.

Psychometric Characteristics, Cross-Cultural Adaptation and Validation of the Slovenian Version of the Victorian Institute of Sports Assessments for Gluteal Tendinopathy Questionnaire (VISA-G)

Introduction

Greater trochanteric pain syndrome (GTPS) denotes several disorders around the lateral aspect of the hip. GTPS may develop in native hips as well as after total hip arthroplasty (THA). It is estimated that 5-12% of patients suffer from GTPS after primary THA. Despite the prevalence of GTPS, it is hard to diagnose and manage it properly. The VISA-G questionnaire was developed as a patient-reported outcome measurement tool for evaluation of GTPS. The aims of the present study were to evaluate the reliability of the VISA-G Slovenian and its construct and criterion validity.

Methods

After the finalization of the VISA-G Slovenian translation procedure, 59 patients with a painful trochanteric region planned for THA filled in the VISA-G Slovenian at the hospital on two occasions 5-7 days apart. On the first occasion, each patient also filled in the EQ-5D-5L questionnaire and the Harris Hip Score (HHS) was completed by the physiotherapist.

Results

The VISA-G Slovenian was found to have a test-retest reliability of ICC 0.977; 95% CI [0.96; 0.986]. Internal consistency was assessed with Cronbach's alpha 0.79. The statistically significant, but low, correlation between the HHS and VISA-G (r=0.48) was obtained. Concurrent validity of the VISA-G with the EQ-5D-5L showed moderate to strong correlations in Mobility, Self-Care, Usual Activities, Pain, EQ-5D-5L Index and EQ VAS, but low correlation in the Anxiety subscale. No floor and ceiling effect were obtained.

Conclusions

The VISA-G Slovenian has excellent psychometric properties needed to measure gluteal tendinopathy-related disability of patients in Slovenia. Thus, we recommend using the questionnaire for measuring trochanteric hip pain.

Cross-Cultural Adaptation and Validation of the Persian Version of the Harris Hip Score

Background

The Persian language, also known as Farsi, is a pluricentric language spoken in Iran, Afghanistan, and Tajikistan by about 140 million people. This study aims to translate the Harris hip score (HHS) into Persian with cross-cultural adaptation and to evaluate its validity and reliability.

Methods

One hundred fifty-six total hip arthroplasty patients completed the Persian version of the HHS, Western Ontario and McMaster Universities Osteoarthritis Index, Forgotten Joint Score, and visual analog scale (VAS) for pain and satisfaction postoperatively. Using Cronbach's alpha (α) coefficient, internal consistency was evaluated. Correlations (Spearman's Rho) were used to assess validity. A test-retest reliability assessment of the Persian HHS was conducted (n = 47) using the intraclass correlation coefficient. Content validity was evaluated using the floor and ceiling effects of the HHS.

Results

The final translation of the Persian HHS was approved to be used. The preoperative and postoperative Cronbach's alpha were 0.71 and 0.70, respectively, and showed acceptable internal consistency. The intraclass correlation coefficient was excellent (0.869, P < .001). Insignificant ceiling effects (13.5%) and no floor effects (0) were observed. The HHS score was significantly and strongly correlated with Western Ontario and McMaster Universities Osteoarthritis Index (r = 0.696, P < .001), VAS pain (r = 0.654, P < .001), VAS satisfaction (r = 0.634, P < .001), and Forgotten Joint Score (r = 0.648, P < .001).

Conclusions

The Persian HHS demonstrated excellent reliability and validity properties. Accordingly, Persian HHS may be a helpful tool for assessing patients undergoing total hip arthroplasty.

Femoral neck fractures in non-geriatric patients: femoral neck system versus cannulated cancellous screw

BACKGROUND

The fractures of femoral neck account for 50% among hip fractures with around 3%-10% occurring in younger population of below 65 years. The newly introduced FNS as management approach appears to be a potential alternative to the traditional CCS. The aim of this study was to compare the clinical efficacy and outcome of the femoral neck system (FNS) and the cannulated cancellous screw (CCS) in the treatment of femoral neck fractures in adult below 65 years of age.

METHODS

Data of 114 patients between 18-65 years, admitted in our department for femoral neck fracture from January 2019 to March 2021 were retrospectively studied and ranged into two groups based on the surgical methods: FNS group (56 patients) and CCS group (58 patients). The variables of interest including demographic and clinical variables (age, gender, fracture mechanism, injury side and classification), perioperative parameters(operation time, intraoperative bleeding, incision length and hospitalization time), postoperative outcomes and complications (fracture healing time, nonunion rate, femoral neck avascular necrosis, aseptic screw loosening and the Harris Hip Score), were analyzed and compared between the two groups.

RESULTS

All 114 patients presented satisfactory reduction and were followed-up for a period of 12 to 36 months (mean 27 ± 2.07 months); there were no significant differences between both groups in terms of age, gender, fracture classification, side of injury, mechanism of injury, the operative time, intraoperative blood loss and the hospital length of stay. However, the fracture healing time between FNS group and CCS group was statistically significant (p < 0.05), respectively 2.86 ± 0.77 and 5.10 ± 0.81 months. The significant differences were also found in terms of numbers of fluoroscopies 8.34 ± 1.38 Vs 17.72 ± 2.19, the HHS 87.80 ± 1.92 Vs 84.28 ± 2.24, postoperative complications 8 (14.28%) Vs 26 (44.82) respectively in FNS and CCS group.

CONCLUSION

FNS presented satisfactory outcomes had significantly lower complications rate, therefore, can be one of the alternatives for internal implantation devices in treatment of femoral neck fracture in non-geriatric population.

Validity and Reliability of the Thai Version of the Modified Harris Hip Score for Patients With Hip Abnormalities

Background:

The modified Harris Hip Score (mHHS) is one of the more commonly used patient-reported outcome measures to evaluate and monitor treatment in patients with hip abnormalities and has been translated into several languages.

Purpose:

To develop a Thai version of the mHHS (TH-mHHS) and evaluate the validity and reliability of the measure.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

The TH-mHHS was developed using the forward-backward translation method. Patients who presented with hip pain during the first clinic visit completed the Thai version of questionnaires including the mHHS, 36-item Short Form Health Survey (TH-SF36), and Hip disability and Osteoarthritis Outcome Score (TH-HOOS). The validity between the measures was tested using the Spearman correlation coefficient. The test-retest reliability of the TH-mHHS was assessed using the intraclass correlation coefficient, and internal consistency was assessed using the Cronbach alpha.

Results:

A total of 64 patients were enrolled who had a mean age of 52.8 ± 16.6 years (range, 17-80 years). There were 64% female and 36% male participants. The TH-mHHS showed a moderate correlation with all subscales of the TH-HOOS and the total TH-HOOS ( r = 0.50-0.65; P < .01) and a high correlation with the physical functioning subscale and physical component summary of the TH-SF36 ( r = 0.73 and 0.75, respectively; P < .01). The test-retest reliability was excellent, with an intraclass correlation coefficient of 0.95 (95% CI, 0.92-0.97; P < .001). The internal consistency was acceptable, with a Cronbach alpha of .71. No floor or ceiling effects were observed.

Conclusion:

The TH-mHHS showed a moderate to high correlation with the TH-SF36 and TH-HOOS, excellent test-retest reliability, and acceptable internal consistency. This measure can be effectively used for evaluating Thai patients with hip disorders, especially an older and arthritic population.

Comparison of daytime and after-hours surgical treatment of femoral neck fractures

Background

The timing of surgery for femoral neck fractures in young adults remains controversial. Nonetheless, the debate continues about whether orthopedic trauma cases should be operated daytime or after hours.

Aim

This study compared the clinical and radiological outcomes of surgery on femoral neck fractures during daytime versus after-hours.

Patients and Methods

A total of 124 patients aged 18-60 years who were operated for femoral neck fractures between 2015 and 2020 were included in the study. The patients were separated into two groups. Seventy-two patients operated between 08:00 and 17:00 hours were defined as the daytime group and 52 patients operated between 17:01 and 07:59 hours were defined as the after-hours group. Demographic data, reduction quality, duration of operation, intraoperative estimated blood loss (EBL), postoperative complications, revision rates, and postoperative Harris hip score results of the two groups were recorded for analysis.

Results

There was no significant difference between the groups in terms of age, gender, body mass index, smoking, fracture type and follow-up time, reduction quality, postoperative complication rates, revision rates, and Harris hip score results. Waiting times until surgery, operation duration, and intraoperative EBL amounts were, in the daytime group, significantly higher than in the after-hours group.

Conclusion

In this study comparing femoral neck fractures operated on daytime and after-hours in adults, the waiting time until surgery was found to be higher in the daytime group. Operation duration and EBL were higher in the after-hours group.

The Chinese version of the American shoulder and elbow surgeons standardized shoulder assessment form questionnaire, patient self-report section: a cross-cultural adaptation and validation study

Background

The patient self-report section of the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASESp) is one of the most validated and reliable assessment tools. This study aimed to establish a validated Chinese version of ASESp (ASESp-CH).

Methods

A clinical prospective study was performed (ClinicalTrials.gov Identifier: NCT04755049; registered on 2021/02/11). Following the guidelines of forward-backward translation and cross-cultural adaptation, a Chinese version of ASESp was established. Patients older than 18 years with shoulder disorders were included. Patients who could not complete test-retest questionnaires within the interval of 7–30 days and patients who received interventions were excluded. Intraclass correlation (ICC) was calculated for test- retest reliability, whereas internal consistency was determined by Cronbach value. Construct validity was evaluated by comparing the corresponding domains between the ASESp-CH and a validated Chinese version of 36-Item Short Form Health Survey (SF-36).

Results

A total of 86 patients were included with a mean test-retest interval of 12 ± 5.4 days. Test-retest reliability was excellent with an ICC of 0.94. Good internal consistency was found, with a Cronbach alpha of 0.86. Construct validity of the ASESp-CH questionnaire was good. The major domains of the ASESp-CH were significantly correlated with the respective domains in the SF-36 (p <  0.01), except for the domain of stability of ASESp-CH.

Conclusions

The Chinese version of ASESp questionnaire is a highly validated and reliable tool for shoulder disorder assessment.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12891-021-04255-z.