Cross-cultural adaptation and validation of the KOOS, JR questionnaire for assessing knee osteoarthritis in Spanish-speaking patients.

PURPOSE: The present study aims to translate, adapt and validate a Spanish version of the Knee Injury and Osteoarthritis Outcome Score, Joint Replacement (KOOS, JR), including a reliability and validity analysis in patients with knee osteoarthritis (OA). METHODS: This study conducted a prospective validation study following the six stages of the "Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures". Psychometric testing was conducted in patients with knee osteoarthritis. Subjects answered the Spanish KOOS, JR (S-KOOS, JR) and a validated Spanish Oxford Knee Score (S-OKS). Retest was conducted at 10 days. Acceptability, floor and ceiling effect, internal consistency (Cronbach's α), reproducibility (mixed-effect model coefficient [MEMC]) and construct validity (Spearman's correlation; p = 0.05) were assessed. RESULTS: Forty-one patients (mean age: 65.6 ± 5.39; 48.8% female) participated in the study. All patients (100%) answered both scores during the first assessment and 38 (92.7%) during the second assessment. All patient-reported outcomes measures were answered completely (100%). The S-KOOS, JR resulted in 100% acceptability when answered. There were no ceiling or floor effects detected. The Cronbach's α for the S-KOOS, JR was 0.927 and its MEMC was 0.852 (CI 95% 0.636-1.078). The Spearman's correlation between the S-KOOS, JR and the S-OKS was 0.711 (CI 0.345-0.608; p < 0.001) and 0.870 (CI 0.444-0.651; p < 0.001) for the first and second assessments, respectively. CONCLUSION: The S-KOOS, JR has very high internal consistency and reproducibility, with a high correlation with the S-OKS; it is a reliable and valid instrument for characterising Spanish-speaking patients suffering from knee OA. LEVEL OF EVIDENCE: IV.

Peroneal nerve injury with foot drop complicating ankle sprain--a series of four cases with review of the literature.

Foot drop has many etiologies. One rarely mentioned and often neglected reason for foot drop is an acute inversion sprain of the ankle. Over the past 14 years, a collection of 32 cases of foot drop have been compiled in our orthopaedic and physiatric practices. All cases had appropriate evaluations, including electrodiagnostic studies (electromyography and nerve conduction studies) to determine the location and type of injury. Treatment and follow-up are also discussed. Of the 32 case studies, four were caused by a straightforward acute inversion sprain of the ankle. These cases are described with the electrodiagnostic evaluations, treatments, and outcomes. Proposed mechanisms for this type of foot drop are discussed, including traction and compression of the common peroneal nerve as it winds around the neck of the fibula, and possible compression by hematoma. Surgical versus conservative treatment is described. The functional impairment associated with foot drop is detailed.

Localized pigmented villonodular synovitis: arthroscopic diagnosis and management of an "invisible" lesion.

Pigmented villonodular synovitis (PVNS) is a rare disorder that may involve the synovium of joints, bursa, or tendon sheaths. Monoarticular involvement is typical, with the knee most commonly affected. Localized pigmented villonodular synovitis (LPVNS) involves a discrete region of the synovium. Detection and diagnosis of this entity is clinically challenging, and plain radiographs are usually unremarkable. Magnetic resonance imaging (MRI) has been reported to be sensitive for the detection of synovial abnormalities and is the imaging modality of choice in suspected cases of LPVNS. When the diagnosis remains in doubt, arthroscopy may be used for direct visualization of synovial pathology, as well as to obtain tissue for histologic analysis. Definitive treatment may also be performed at the time of arthroscopy. We present a case of LPVNS in which a large (4 cm) lesion was not apparent on preoperative radiographs or MRI and was also missed on initial diagnostic arthroscopy.

Osteoporosis transitoria de la cadera / Transient osteoporosis of the hip

Se describe el caso de una paciente del sexo femenino de 54 años de edad, que presentó dolor súbito de la cadera izquierda. El diagnóstico de osteoporosis transitoria de la cadera se hizo en base al cuadro clínico, estudios de laboratorio y de imagenología (radiografías simples, gammagrafía ósea y resonancia magnética nuclear). No se requiere de biopsia para hace el diagnóstico. Ya que este síndrome se autolimita, el manejo adecuado requiere de un diagnóstico certero y de tratamiento conservador. El tratamiento consiste en analgésicos, proteger al paciente de fracturas de stress, y terapia física para prevenir contracturas