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Cross-cultural adaptation and validation of the Oxford 12-item knee score in Japanese

  • Orthopaedic Outcome Assessment
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

With the high incidence of knee osteoarthritis (OA) in Japan, there is a strong need not only for surgical therapies, but also for validated outcome measures. For this study, we completed cross-cultural adaptation, testing and validation of the Oxford knee score (OKS) for prospective use in national and international clinical studies involving Japanese patients.

Materials and methods

The Japanese version of the OKS was developed according to the standard cross-cultural adaptation guidelines. For validation, the OKS was tested on 54 patients diagnosed with OA, osteonecrosis, ligament or meniscus injury. Reliability was tested using the intraclass correlation coefficient (ICC). Internal consistency or homogeneity was assessed using Cronbach’s alpha. The correlation between the Japanese OKS, WOMAC and SF-36 questionnaires was used to assess construct validity.

Results

No major difficulties were encountered with the translation and pre-testing stages. For reliability and validity, the Japanese OKS was completed without any missed responses by 53 (98.15%) and 52 (96.30%) patients at the first and second distribution, respectively. The total OKS showed good reliability with an ICC of 0.85. Internal consistency was strong (Cronbach’s alpha = 0.90). Strong construct validity (ICC values of 0.51–0.84) was obtained against the WOMAC and SF-36 (physical functioning, role-physical, bodily pain, and social functioning subscales) scores. Notable “ceiling” effects of the OKS were reported for 11 of the 12 questionnaire items.

Conclusion

The Japanese OKS has proven to be a reliable and valid instrument for the self-assessment of knee pain and function in Japanese speaking patients with knee OA and other knee complaints.

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References

  1. Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF (1987) The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum 30(8):914–918

    Article  CAS  PubMed  Google Scholar 

  2. Aoda H, Nakamura K, Omori G, Koga Y, Akazawa K, Yamamoto M (2006) Independent predictors of knee osteoarthritis in an elderly Japanese population—a multivariate analysis. Acta Med Biol 54(2):33–41

    Google Scholar 

  3. Felson DT, Zhang Y, Hannan MT, Naimark A, Weissman BN, Aliabadi P, Levy D (1995) The incidence and natural history of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum 38(10):1500–1505

    Article  CAS  PubMed  Google Scholar 

  4. Muraki S, Oka H, Akune T, Mabuchi A, En-yo Y, Yoshida M, Ishibashi H, Yamamoto S, Nakamura K, Kawaguchi H, Yoshimura N (2009) Prevalence of radiographic knee osteoarthritis and its association with knee pain in the elderly of Japanese population-based cohorts: the ROAD study. Osteoarthr Cartil 17(9):1137–1143

    Article  CAS  PubMed  Google Scholar 

  5. Koshino T, Saito T, Orito K, Mitsuhashi S, Takeuchi R, Kurosaka T (2002) Increase in range of knee motion to obtain floor sitting after high tibial osteotomy for osteoarthritis. Knee 9(3):189–196

    Article  PubMed  Google Scholar 

  6. Tamari K (2002) Gender and age related differences in axial alignment of the lower limb among healthy Japanese population—comparative and correlational study. J Jpn Phys Ther Assoc 29:199

    Google Scholar 

  7. Tamari K, Tinley P, Briffa K, Aoyagi K (2006) Ethnic-, gender-, and age-related differences in femorotibial angle, femoral antetorsion, and tibiofibular torsion: cross-sectional study among healthy Japanese and Australian Caucasians. Clin Anat 19(1):59–67

    Article  PubMed  Google Scholar 

  8. Koshino T, Yoshida T, Ara Y, Saito I, Saito T (2004) Fifteen to twenty-eight years’ follow-up results of high tibial valgus osteotomy for osteoarthritic knee. Knee 11(6):439–444

    Article  PubMed  Google Scholar 

  9. Takeuchi R, Ishikawa H, Aratake M, Bito H, Saito I, Kumagai K, Akamatsu Y, Saito T (2009) Medial open wedge high tibial osteotomy with early full weight bearing. Arthroscopy 25(1):46–53

    Article  PubMed  Google Scholar 

  10. Saito T, Takeuchi R, Yamamoto K, Yoshida T, Koshino T (2003) Unicompartmental knee arthroplasty for osteoarthritis of the knee: remaining postoperative contracture affecting overall results. J Arthroplasty 18(5):612–618

    Article  CAS  PubMed  Google Scholar 

  11. Nagamine R, Miura H, Bravo CV, Urabe K, Matsuda S, Miyanishi K, Hirata G, Iwamoto Y (2000) Anatomic variations should be considered in total knee arthroplasty. J Orthop Sci 5(3):232–237

    Article  CAS  PubMed  Google Scholar 

  12. Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14

    PubMed  Google Scholar 

  13. The Japanese Orthopaedic Association (1992) The assessment criteria of treatment for knee osteoarthritis. J Jpn Orthop Assoc 66:1212–1219

    Google Scholar 

  14. Akai M, Doi T, Fujino K, Iwaya T, Kurosawa H, Nasu T (2005) An outcome measure for Japanese people with knee osteoarthritis. J Rheumatol 32(8):1524–1532

    PubMed  Google Scholar 

  15. Hashimoto H, Hanyu T, Sledge CB, Lingard EA (2003) Validation of a Japanese patient-derived outcome scale for assessing total knee arthroplasty: comparison with Western Ontario and McMaster Universities osteoarthritis index (WOMAC). J Orthop Sci 8(3):288–293

    Article  PubMed  Google Scholar 

  16. Haverkamp D, Sierevelt IN, Breugem SJ, Lohuis K, Blankevoort L, van Dijk CN (2006) Translation and validation of the Dutch version of the International Knee Documentation Committee Subjective Knee Form. Am J Sports Med 34(10):1680–1684

    Article  PubMed  Google Scholar 

  17. Naal FD, Impellizzeri FM, Sieverding M, Loibl M, von Knoch F, Mannion AF, Leunig M, Munzinger U (2009) The 12-item Oxford Knee Score: cross-cultural adaptation into German and assessment of its psychometric properties in patients with osteoarthritis of the knee. Osteoarthr Cartil 17(1):49–52

    Article  CAS  PubMed  Google Scholar 

  18. Padua R, Zanoli G, Ceccarelli E, Romanini E, Bondi R, Campi A (2003) The Italian version of the Oxford 12-item Knee Questionnaire—cross-cultural adaptation and validation. Int Orthop 27(4):214–216

    Article  CAS  PubMed  Google Scholar 

  19. Xie F, Li SC, Lo NN, Yeo SJ, Yang KY, Yeo W, Chong HC, Fong KY, Thumboo J (2007) Cross-cultural adaptation and validation of Singapore English and Chinese versions of the Oxford Knee Score (OKS) in knee osteoarthritis patients undergoing total knee replacement. Osteoarthr Cartil 15(9):1019–1024

    Article  CAS  PubMed  Google Scholar 

  20. Dawson J, Fitzpatrick R, Murray D, Carr A (1998) Questionnaire on the perceptions of patients about total knee replacement. J Bone Jt Surg Br 80(1):63–69

    Article  CAS  Google Scholar 

  21. Clarke S, Lock V, Duddy J, Sharif M, Newman JH, Kirwan JR (2005) Intra-articular hylan G-F 20 (Synvisc) in the management of patellofemoral osteoarthritis of the knee (POAK). Knee 12(1):57–62

    Article  PubMed  Google Scholar 

  22. Raman R, Dutta A, Day N, Sharma HK, Shaw CJ, Johnson GV (2008) Efficacy of Hylan G-F 20 and sodium hyaluronate in the treatment of osteoarthritis of the knee—a prospective randomized clinical trial. Knee 15(4):318–324

    Article  CAS  PubMed  Google Scholar 

  23. Weale AE, Lee AS, MacEachern AG (2001) High tibial osteotomy using a dynamic axial external fixator. Clin Orthop Relat Res 382:154–167

    Article  PubMed  Google Scholar 

  24. Weil YA, Gardner MJ, Boraiah S, Helfet DL, Lorich DG (2008) Posteromedial supine approach for reduction and fixation of medial and bicondylar tibial plateau fractures. J Orthop Trauma 22(5):357–362

    Article  PubMed  Google Scholar 

  25. Guillemin F, Bombardier C, Beaton D (1993) Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 46(12):1417–1432

    Article  CAS  PubMed  Google Scholar 

  26. Beaton DE, Bombardier C, Guillemin F, Ferraz MB (2000) Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 25(24):3186–3191

    Article  CAS  PubMed  Google Scholar 

  27. Murray DW, Fitzpatrick R, Rogers K, Pandit H, Beard DJ, Carr AJ, Dawson J (2007) The use of the Oxford hip and knee scores. J Bone Jt Surg Br 89(8):1010–1014

    Article  CAS  Google Scholar 

  28. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15(12):1833–1840

    CAS  PubMed  Google Scholar 

  29. Bellamy N, Campbell J, Stevens J, Pilch L, Stewart C, Mahmood Z (1997) Validation study of a computerized version of the Western Ontario and McMaster Universities VA3.0 Osteoarthritis Index. J Rheumatol 24(12):2413–2415

    CAS  PubMed  Google Scholar 

  30. Bellamy N, Goldsmith CH, Buchanan WW, Campbell J, Duku E (1991) Prior score availability: observations using the WOMAC osteoarthritis index. Br J Rheumatol 30(2):150–151

    Article  CAS  PubMed  Google Scholar 

  31. Roos EM, Klässbo M, Lohmander LS (1999) WOMAC osteoarthritis index. Reliability, validity, and responsiveness in patients with arthroscopically assessed osteoarthritis. Western Ontario and MacMaster Universities. Scand J Rheumatol 28(4):210–215

    Article  CAS  PubMed  Google Scholar 

  32. Brazier JE, Harper R, Jones NM, O’Cathain A, Thomas KJ, Usherwood T, Westlake L (1992) Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ 305(6846):160–164

    Article  CAS  PubMed  Google Scholar 

  33. Cronbach L (1951) Coefficient alpha and the internal structure of tests. Psychometrika 16:297–334

    Article  Google Scholar 

  34. Boyle GJ (1991) Does item homogeneity indicate internal consistency or item redundancy in psychometric scales? Personal Individ Differ 12:291–294

    Article  Google Scholar 

  35. Gross Portney L, Watkins MP (2010) Statistical measure of reliability. In: Gross Portney L, Watkins MP (eds) Foundations of clinical research—applications to practice, 3rd edn. Pearson–Prentice Hall, New Jersey, pp 585–618

  36. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC (2007) Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 60(1):34–42

    Article  PubMed  Google Scholar 

  37. Dunbar MJ, Robertsson O, Ryd L, Lidgren L (2000) Translation and validation of the Oxford-12 item knee score for use in Sweden. Acta Orthop Scand 71(3):268–274

    Article  CAS  PubMed  Google Scholar 

  38. Charoencholvanich K, Pongcharoen B (2005) Oxford knee score and SF-36: translation and reliability for use with total knee arthroscopy patients in Thailand. J Med Assoc Thai 88(9):1194–1202

    PubMed  Google Scholar 

  39. Al-Atiyyat NMH (2009) Cultural diversity and cancer pain. J Hosp Palliat Nurs 11(3):154–164

    Article  Google Scholar 

  40. Brena SF, Sanders SH, Motoyama H (1990) American and Japanese chronic low back pain patients: cross-cultural similarities and differences. Clin J Pain 6(2):118–124

    Article  CAS  PubMed  Google Scholar 

  41. Lingard EA, Sledge CB, Learmonth ID (2006) Patient expectations regarding total knee arthroplasty: differences among the United States, United Kingdom, and Australia. J Bone Jt Surg Am 88(6):1201–1207

    Article  Google Scholar 

  42. Joshy S, Datta A, Perera A, Thomas B, Gogi N, Kumar SB (2006) Ethnic differences in preoperative function of patients undergoing total knee arthroplasty. Int Orthop 30(5):426–428

    Article  PubMed  Google Scholar 

  43. Nilchaikovit T, Hill JM, Holland JC (1993) The effects of culture on illness behavior and medical care. Asian and American differences. Gen Hosp Psychiatry 15(1):41–50

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

The authors would like to acknowledge Toshinao Sawai and Naohiko Banno from Synthes K.K. and Drs Takao Maruyama and Shiro Watanabe from the Shonan Daiichi hospital for their administrative support.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Yokohama City University School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    R. Takeuchi, H. Ishikawa & T. Saito

  2. Department of Orthopaedics and Joint Reconstructive Surgery, Toyama Municipal Hospital, 2-1, Imaizumi-Hokubu, Toyama, 939-8511, Japan

    T. Sawaguchi

  3. Department of Rehabilitation Science, Osaka Health Science University, 1-9-27 Tenma, Kita-ku, Osaka, 530-0043, Japan

    N. Nakamura

  4. AO Clinical Investigation and Documentation, Stettbachstrasse 6, 8600, Dübendorf, Switzerland

    S. Goldhahn

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  1. R. Takeuchi
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  4. H. Ishikawa
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Correspondence to S. Goldhahn.

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Takeuchi, R., Sawaguchi, T., Nakamura, N. et al. Cross-cultural adaptation and validation of the Oxford 12-item knee score in Japanese. Arch Orthop Trauma Surg 131, 247–254 (2011). https://doi.org/10.1007/s00402-010-1185-1

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  • DOI: https://doi.org/10.1007/s00402-010-1185-1

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