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Knee Surgery, Sports Traumatology, Arthroscopy
https://doi.org/10.1007/s00167-020-06211-1
KNEE
Cross‑cultural validation of Hindi version Knee Injury
and Osteoarthritis Outcome Score (KOOS) in osteoarthritis knee
Ranjan Kumar Jha
1
· Ramesh Kumar Sen
2
· Sujit Kumar Tripathy
3
· Nirmal Raj Gopinathan
1
· Tarun Goyal
4
·
Suresh Kumar Sharma
5
Received: 12 June 2020 / Accepted: 3 August 2020
© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020
Abstract
Purpose To assess the reliability, validity and responsiveness of the Hindi version of the Knee Injury and Osteoarthritis
Outcome Score (H-KOOS) in osteoarthritic knee.
Methods Two hundred and fourteen patients of osteoarthritis knee (OA) between 40 and 80 years of age were evaluated with
H-KOOS, Short form health survey (SF12v2) and the WHOQOL-BREF questionnaire. The H-KOOS was re-evaluated after
48 h in 125 patients to assess the test–retest reliability. For responsiveness, 40 patients were treated with the intra-articular
hyaluronic acid injection, and the efect was assessed after 6 weeks.
Results Most of the domains in H-KOOS did not show a ceiling efect. The foor values were observed in 3.75% of patients
in sports/recreation function and 2.75% of patients in Quality of life (QoL). The test–retest reliability was excellent with
the Intraclass-Correlation-Coefcient (ICC) ranging from 0.89 to 0.94. Internal consistency as assessed using Cronbach‘s
alpha coefcient was acceptable for pain, activities of daily living (ADL) and sport/recreation function (range 0.86–0.93);
however, symptoms and QoL had weak internal consistency. There were moderate to strong correlations (r = 0.35 to 0.6)
between domains measuring similar constructs in H-KOOS, SF12v2 and WHOQOL-BREF indicating good convergent
construct validity. The responsiveness as measured by the efect size (ES) and standardized response mean (SRM) was large
for pain (ES 0.9, SRM 0.8), moderate for Sport/Rec (ES 0.66, SRM 0.2) and small for ADL, QoL and Symptoms subscales.
Conclusion The Hindi version KOOS is a valid, reliable and responsive measure to evaluate osteoarthritis knee with minimal
ceiling and foor efects.
Level of evidence Prospective cohort study, level II.
Keywords KOOS · Knee injury · Knee osteoarthritis · Measurement properties · Patient-reported outcome measures ·
Psychometrics
Introduction
Recently, patient-reported outcome measures have been
considered as one of the appropriate assessment methods
to evaluate the hip and knee function in arthritic conditions,
both before and after treatment [8]. Before the widespread
clinical and research use of such outcome scale in a com-
munity, it should be rigorously tested for validity, reliability
and responsiveness [1, 8].
The Knee Injury and Osteoarthritis Outcome Score
(KOOS) questionnaire is such a patient-reported outcome
measure for knee assessment in osteoarthritis and traumatic
conditions [9, 18]. The details of the KOOS were published
for the frst time in 1998, and since then, the psychometric
properties of KOOS have been evaluated in many studies
Electronic supplementary material The online version of this
article (https://doi.org/10.1007/s00167-020-06211-1) contains
supplementary material, which is available to authorized users.
* Sujit Kumar Tripathy
sujitortho@yahoo.in; sujitortho@aiimsbhubaneswar.edu.in
1
Department of Orthopaedics, Postgraduate Institute
of Medical Education and Research, Chandigarh, India
2
Max Hospital, Mohali, Chandigarh, India
3
Department of Orthopaedics, AIIMS, Bhubaneswar, India
4
Department of Orthopaedics, AIIMS, Bhathinda, India
5
Department of Biostatistics, Punjab University, Chandigarh,
India