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The German version of the High-Activity Arthroplasty Score is valid and reliable for patients after total knee arthroplasty

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The indications for a total knee arthroplasty (TKA) broadened to younger and more active patients. The High-Activity Arthroplasty Score (HAAS) is a self-administered instrument focussing on the wider range of functional abilities of more active patients. The HAAS was developed in English and is not available in German yet. This study aims to translate, cross-cultural adapt and assess the psychometric properties of the German HAAS in patients 12 months after primary TKA.

Methods

After forward and backward translation, we examined the final version regarding its psychometric properties in patients 12 months after primary TKA. The HAAS was sent out to 70 patients together with routine questionnaires comprising the Knee injury and Osteoarthritis Outcome Score (KOOS), the Forgotten Joint Score (FJS-12), the EuroQol (EQ-5D-3L) and 2 numerical pain rating scales. Acceptability, reliability, responsiveness, content and construct validity as well as floor and ceiling effects were evaluated.

Results

Fifty-two patients were recruited. The HAAS was well accepted with a mean time to completion of 2.4 min. Cronbach’s alpha for internal consistency was 0.749, test–retest reliability was excellent with an Intraclass Correlation Coefficient (ICC) of 0.961. The smallest detectable change was 1.5. Good content validity was confirmed. A strong correlation was found between the HAAS and KOOS sport (r = 0.661) and a medium correlation for all other KOOS subscales (r = 0.324 to 0.453), the FJS-12 (r = 0.425), the EQ-5D-3L (r = 0.427) and pain (r = − 0.439 to − 0.308). The HAAS showed no floor and ceiling effects.

Conclusions

The German version of the HAAS provides good validity and reliability. It can be easily self-administered and is recommended to capture high-intensity activities in patients after TKA.

Level of evidence

Diagnostic study, Level I.

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Abbreviations

ADL:

Activities of daily living

CI:

Confident interval

COSMIN:

Consensus-Based Standards for the Selection of Health Status Measurement Instruments

EQ-5D-3L:

EuroQol five dimensions three levels

FJS-12:

Forgotten Joint Score

GRRAS:

Guidelines for Reporting Reliability and Agreement Studies

HAAS:

High-Activity Arthroplasty Score

ICC:

Intraclass Correlation Coefficient

KOOS:

Knee injury and Osteoarthritis Outcome Score

PROM:

Patient-reported outcome measure

QoL:

Quality of life

SD:

Standard deviation

SDC:

Smallest detectable change

SEM:

Standard error of measurement

THA:

Total hip arthroplasty

TKA:

Total knee arthroplasty

VAS:

Visual analogue scale

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Acknowledgments

We thank Marlee MacDonald and Karin Schad for their contributions to the translation of the HAAS.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Practice LEONARDO, Hirslanden Klinik Birshof, Münchenstein, Switzerland

    Nicole Vogel, Raphael Kaelin, Thomas Rychen & Markus P. Arnold

  2. Faculty of Medicine, University of Basel, Basel, Switzerland

    Nicole Vogel & Markus P. Arnold

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  1. Nicole Vogel
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  2. Raphael Kaelin
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Correspondence to Nicole Vogel.

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All authors declare to have no conflict of interest.

Ethical approval

The study was approved by the local ethics committee (ID: 2016-01777).

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Written informed consent was obtained from all participants included in this study.

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Vogel, N., Kaelin, R., Rychen, T. et al. The German version of the High-Activity Arthroplasty Score is valid and reliable for patients after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 30, 1204–1211 (2022). https://doi.org/10.1007/s00167-021-06531-w

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