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The KOOS outcome measure was successfully translated into Italian, and proved to have good psychometric properties that replicated the results of existing versions. Its use is recommended for clinical and research purposes in patients with knee injuries.

The KOOS was sensitive in detecting clinical changes. The authors recommend taking the minimal important changes provided into account when assessing patient improvement or planning studies in this clinical context.

The Chinese (traditional), Dutch, Italian, Norwegian, and Spanish translations are advisable; the Greek, Japanese, Korean, Persian, Thai, and Turkish translations showed encouraging results but should be used with caution; the Brazilian, Chinese (simplified), Polish, and Swedish translations showed contradictory or scarce results, and no suggestions can be formulated; the French Canadian and German translations did not provide methodologically sound information. Further attention should be given to cross-cultural and structural validity, hypothesis testing, and responsiveness.

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