Cross-cultural adaptation and validation of the Filipino translation of the knee injury and osteoarthritis outcome score in Filipinos with knee osteoarthritis at a tertiary hospital

Objectives@#1) To translate and cross-culturally adapt the Knee Injury and Osteoarthritis Outcome Score (KOOS) into Filipino; 2) To validate the Filipino translation of KOOS using the Filipino Short-Form 36 Health Survey (SF-36) among patients with knee osteoarthritis (kOA) at a tertiary hospital. @*Methodology@#A Filipino version of the KOOS was translated and cross-culturally adapted from the original English version and validated following standard guidelines. Adult Fiipino patients with knee osteoarthritis at the University of the Phiippines-Philippine General Hospital were asked to complete identical questionnaires containing the Filipino KOOS and Filipino SF-36, with re-test on the same patients after a median of 14 days. Reliability was assessed using Cronbach’s alpha and intraclass correlation coefficients (ICC); dimensionality using convergent and divergent construct validity. @*Results@#The Filipino translation of the KOOS was administered to 30 patients with knee OA (kOA). Cronbach's α across the Filipino KOOS domains ranged from 0.71 to 0.89 suggesting good internal consistency. The reproducibility of measurements of all KOOS subscales by ICC ranged from 0.97 to 1.0. For convergent construct validity, there was moderate correlation between KOOS ADL (0.38, p =0.03) and knee-related QoL (0.42, p=0.02) by SF-36 Physical Functioning (PF). A strong correlation (0.51, p=0.003) was observed between KOOS sports and recreation domain with SF-36 PF. For divergent construct validity, there was weak correlation between KOOS pain (0.015, p=0.93) and symptoms (0.15, p=0.42) with SF 36 Social Functioning. @*Conclusion@#The Filipino version of the KOOS is a valid and reliable instrument to measure the different aspects of disability affecting quality of life of Filipino patients with kOA.

Effect of acupuncture on knee injury and osteoarthritis outcome score in patients with knee osteoarthritis / 中国针灸

OBJECTIVE@#To verify the clinical effect of acupuncture on knee osteoarthritis (KOA).@*METHODS@#Forty-two patients with KOA were randomly divided into an acupuncture group (21 cases, 1 case dropped off) and a sham acupuncture group (21 cases, 1 case dropped off). The patients in the acupuncture group were treated with routine acupuncture at 5-6 local acupoints [Dubi (ST 35), Neixiyan (EX-LE 4), Heding (EX-LE 2), Yinlingquan (SP 9), Xuehai (SP 10), Zusanli (ST 36), etc.] and 3-4 distal acupoints [Fengshi (GB 31), Waiqiu (GB 36), Xuanzhong (GB 39), Zulinqi (GB 41), etc.]. The patients in the sham acupuncture group were treated with shallow needling technique at non-acupoint. The needles were retained for 30 min in both groups. All the treatment was given three times a week for 8 weeks. Knee injury and osteoarthritis outcome score (KOOS) were recorded before and after treatment and 18-week follow-up.@*RESULTS@#Compared before treatment, the scores of 5 dimensions of KOOS [pain, symptoms (except pain), daily activities, sports and entertainment, and quality of life] were increased after treatment and during follow-up in the two groups (@*CONCLUSION@#Acupuncture can reduce the pain symptoms and improve daily activities in patients with KOA.

Comparison of 3d printing assisted osteotomy of distal femur and osteotomy of distal femur in the treatment of genu valgus osteoarthritis / 中国组织工程研究

BACKGROUND: Closed osteotomy of distal femur has a good effect in the treatment of genu valgus osteoarthritis, but the angle of osteotomy cannot be measured directly during the operation. It is necessary to correct the force line through repeated fluoroscopy and adjustment of osteotomy amount. Improper operation may cause iatrogenic rotation deformity. OBJECTIVE: To compare the effect of 3D printing assisted osteotomy of distal femur with conventional osteotomy of distal femur in the treatment of knee osteoarthritis. METHODS: From January 2014 to February 2018, 28 patients (37 knees in total) with osteoarthritis caused by genu valgus aged 28-60 years were enrolled from the First Hospital of Putian City. All patients were randomly divided into two groups. Patients in the control group (11 cases, 16 knees) were treated with conventional closed osteotomy of distal femur combined with locking compression plate implantation. Patients in the experimental group (17 cases, 21 knees) were treated with 3D printing module assisted with closed osteotomy of distal femur combined with locking compression plate. The operation time and times of fluoroscopy were recorded. The KOOS score, femorotibial angle, lateral angle of distal femur and fracture healing time were compared between the two groups before and after treatment. The experiment was approved by the Ethics Committee of the First Hospital of Putian City. RESULTS AND CONCLUSION: (1) Operation time and the times of fluoroscopy in the experimental group were less than those in the control group (P 0.05). (3) Femorotibial angle and lateral angle of distal femur in both groups were larger than those before operation (P 0.05). (4) There was no significant difference in the healing time between the two groups (P > 0.05). (5) The results showed that closed osteotomy of the distal femur can achieve good results in the treatment of genu valgus osteoarthritis. 3D printing technology can simplify the osteotomy operation, reduce the operation time, and the times of fluoroscopy.

Test-retest reliability, internal consistency, and discriminant validity of the Filipino version of Knee injury and Osteoarthritis Outcome Score among community-dwellers with knee osteoarthritis

Objective@#This study aimed to determine the test-retest reliability, internal consistency, and discriminant validity of the Filipino Knee injury and Osteoarthritis Outcome Score (F-KOOS) among community-dwellers with knee osteoarthritis (OA). The study also examined the suitability of the F-KOOS in terms of relevance and ease of understanding@*Methods@#This psychometric study utilized a cross-sectional design. Participants (>50 years old) with knee pain and soreness were recruited from the community and were medically diagnosed with knee OA according to the American College of Rheumatology clinical criteria. Participants were instructed to report for two sessions approximately two weeks apart. Descriptive statistics were used to describe the characteristics of participants and suitability in answering F-KOOS. Test-retest reliability and internal consistency were determined through intraclass correlation coefficients (ICCs) and Cronbach alpha, respectively. Discriminant validity was examined by comparing those with and without knee OA using independent t-test (p<0.05) per F-KOOS subscale. @*Results and Discussion@#A total of 53 participants (35 females, 18 males) with a mean age of 69.67+5.83 years old were included in the study. The domains of the KOOS in the pre-test and re-test range from 0.30 to 0.78 (p<0.05), indicating good test-retest reliability between two assessment points. All domains of the F-KOOS had high internal consistency (Cronbach alpha of > 0.7) ranging from 0.87 to 0.96. Discriminant validity of all domains of F-KOOS between participants diagnosed with and without knee OA showed p-values <0.01 which indicate a significant difference between both groups. In terms of preference, out of 40 participants who answered the survey, 55-85% expressed ease and satisfaction in answering F-KOOS.@*Conclusion@#The study demonstrated that the F-KOOS has an acceptable test-retest reliability, good internal consistency, and discriminant validity in individuals with knee OA. The study further determined that the use of the F-KOOS is appropriate, relevant, and easy to understand in the community setting.

Incremental cost-effectiveness and tolerability of Diclofenac + Proton pump inhibitor compared to tramadol in the treatment of knee osteoarthritis

Background: In a climate of economic uncertainty, cost effectiveness analysis is a potentially important tool for making choices about health care interventions. Patients with knee osteoarthritis are treated mostly with Diclofenac (NSAID) + Proton Pump Inhibitors (PPI) and Tramadol (Opioids) in everyday practice.Aim: Present study was aimed to assess clinical effectiveness, adverse events and cost-effectiveness between Diclofenac + PPI and Tramadol.Methods: Authors conducted prospective randomised control open label study on 40 patients at Orthopedic OPD of tertiary care hospital. Patients were given either Tramadol controlled releases tablets (200mg CR OD) or Diclofenac sustained release tablets (100mg SR OD) + PPI (Omeprazole 20mg OD) for two weeks. Clinical effectiveness was assessed by KOOS osteoarthritis index score consisting of five parameters and visual analogue scale. Suspected ADRs were recorded and incremental cost effective ratio for both drugs was calculated.Results: After application of KOOS questionnaire Authors found net quality gain in symptoms was 24.45 in diclofenac +PPI group which was much higher against 14.15 found in tramadol group. Again ADR profile of tramadol was 29 with nausea and somnolence topping the list which was far more than only 10 in DIC +PPI group. Lastly cost-effective analysis was done where again DIC+PPI showed average cost effective ratio 5.73 verses tramadol 11.8 with an incremental cost-effectiveness ratio (ICER) of -2.72.Conclusions: Diclofenac +PPI is as effective as tramadol in the treatment of pain due to knee osteoarthritis with the potential for feAuthorsr side effects. Diclofenac + PPI was also found to be cost-effective when compared with tramado.

Clinical efficacy of resveratrol as an adjuvant with meloxican in the treatment of knee osteoarthritis patients: A double-blind, randomised, placebo-controlled trial

The present study aimed to evaluate the effect of the adjuvant use of resveratrol with meloxicam on the clinical scores of knee OA patients. This was a double-blind placebo-controlled randomised trial involving 100 patients with knee osteoarthritis performed at the Shar Teaching Hospital, Sulaimani General Hospital and Specialised Rheumatology Center, Sulaimani City from December 2016 to September 2017. The efficacy of the treatment was evaluated by measuring the changes from baseline in the KOOS score, WOMAC index, and VAS-100 score after 90 days of treatment. Resveratrol significantly improves the knee OA pain and associated symptoms compared with placebo, and both clinical scores were found to be eligible for following treatment outcomes. In conclusion, resveratrol, when used in combination with meloxicam, improves pain and symptom scores in patients with mild-to-moderate knee OA compared with placebo. The intervention with a dietary supplement may significantly impact the pain and overall quality of life in patients with knee OA.

Schwannoma gigante del ángulo pontocerebeloso / Giant Schwannoma of the cerebellopontine angle

Los Schwannomas del acústico son tumores benignos de crecimiento lento de la división superior del nervio vestibular, con una incidencia de 1,9 por cada 100.000 habitantes. En la actualidad, la tecnología de la neuroimagen en conjunto con la exploración audiológica clínica e instrumentada permiten el diagnóstico en estadios tempranos e incluso como hallazgo clínico, por tal motivo solo el 6 % a nivel mundial se cataloga como tumor grande al momento del diagnóstico. Se presenta el caso de una mujer de 16 años con cefalea, mareo, vómito, hipoacusia, parálisis facial y diadococinesia, por lo que se realizaron estudios de neuroimagen en los que se evidenció masa ocupativa a nivel ángulo pontocerebeloso; por las dimensiones se cataloga según la clasificación de Koss como estadio IV. Se confirmó diagnóstico mediante estudio histopatológico.

Acoustic schwannomas are benign tumors of slow growth in the top division of the vestibular nerve, with an incidence of 1.9 per 100,000 inhabitants. Currently, imaging technology together with the clinical examination audiological and implemented allow diagnosis at an early stage and even as a clinical finding, on that ground only 6 % worldwide are categorized as large tumor at diagnosis. For a woman of 16 with headache, dizziness , vomiting , hearing loss, facial paralysis and diadochokinesia occurs, so neuroimaging studies in which a space- occupying mass level cerebellopontine angle were made evident ; by the dimensions it is classified as classified as stage IV Koss . Diagnosis was confirmed by histopathology.

Psychometric Properties of the Malay Language Version of Knee Injury and Osteoarthritis Outcome Score (KOOS) Questionnaire among Knee Osteoarthritis Patients: A Confirmatory Factor Analysis

Introduction: This study aimed to cross-culturally adapt a Malay version of Knee Injury and Osteoarthritis Outcome Score (KOOS) and to evaluate its psychometric properties in patients with knee osteoarthritis (OA). Materials and Methods: The English version KOOS was translated into a Malay version using forward and backward translation process, followed by face validity and content validity. Two hundred and twenty-six knee OA patients attending the Outpatient and Orthopaedic Clinics, Universiti Sains Malaysia Hospital, completed the Malay version KOOS. Construct validity using confirmatory factor analysis and internal reliability assessment were performed. Results: The results showed that the original five-factor model with 42 items failed to achieve acceptable values of the goodness of fit indices, indicating poor model fit. A new five-factor model of 26 items demonstrated acceptable level of goodness of fit (comparative fit index= 0.929, incremental fit index= 0.930, Tucker Lewis fit index= 0.920, root mean square error of approximation= 0.073 and Chisquared/degree of freedom= 2.183) indices to signify a model fit. The Cronbach’s alpha value for the new model ranged from 0.776 to 0.946. The composite reliability values of each construct ranged between 0.819 and 0.921, indicating satisfactory to high level of convergent validity. Conclusion: The five-factor model with 26 items in the Malay version of KOOS questionnaire demonstrated a good degree of goodness of fit and was found to be valid, reliable and simple as an assessment tool for symptoms, pain activity of daily living, sports and recreational activity and quality of life for Malaysian adults suffering from knee osteoarthritis.

Assessment of Validity, Reliability and Responsiveness of Korean Knee Injury and Osteoarthritis Outcome Score(KOOS) for the Knee Injury / 대한정형외과학회잡지

PURPOSE: To assess the suitability of the Korean KOOS (Knee injury and osteoarthritis outcome score) as a patient-centered clinical measurement of the validity, reliability and responsiveness to the treatment of knee injuries. MATERIALS AND METHODS: One hundred and eight patients who had experienced an arthroscopic ACL reconstruction or a menisectomy between Jan. 2002 and Jun. 2003 were examined immediately after surgery, and 6 and 12 months after surgery. The SF-36 and Lysholm knee scale were administered simultaneously to each case in order to calculate the inter-item correlation. RESULTS: Measurements of the test-retest reliability showed that all intra-class coefficients (ICC) were measured as r=0.75-0.89 and Cronbach's alpha was 0.73-0.81. Regarding the validity, there was a strong correlation with the SF-36 and the Lysholm, subscales (SF-36 vs KOOS: Physical functioning vs ADL (r=0.67)/Physical functioning vs Sports and recreational activities (r=0.61)/Bodily pain vs Pain (r=0.63)). In terms of the responsiveness, the average score measured preoperatively, and three, six and nine months showed a gradual increase. The effect size of pain, symptoms and ADL at postoperative 6 months was 0.8-1.1. A larger effect size was observed in the QOL (1.5) and sports and recreational function (1.3) at 3 months after surgery (n=25). CONCLUSION: The validity, reliability and responsiveness of the Korean KOOS was confirmed and is considered to be a useful clinical metrology for a knee injury.