Cross-cultural adaptation and validation of the Italian versions of the Kujala, Larsen, Lysholm and Fulkerson scores in patients with patellofemoral disorders

Abstract

BackgroundThe Kujala, Fulkerson, Larsen and Lysholm questionnaires have been demonstrated to be reliable and sensitive in assessing patients with patellofemoral pathology. The purpose of this study is to translate and cross-culturally adapt into Italian the English versions of the Kujala, Fulkerson, Larsen and Lysholm questionnaires, and undertake reliability and validity evaluations of the Italian versions of these scores in patients with patellofemoral pathology.Materials and methodsThe cross-cultural adaptation process was carried out following the simplified Guillemin criteria. The questionnaires were administered to 63 patients with either patellar instability or painful patella syndrome. To assess the validity of the questionnaires, they were compared with the Oxford knee score. The questionnaires were administered to a subsample of 33 patients 5 days later to assess test–retest reliability.ResultsThe interclass coefficient correlation was 0.96 for the Kujala score, 0.92 for the Larsen score, 0.96 for the Lysholm score, 0.94 for the Fulkerson score (P < 0.01), and 0.83 for the Oxford score. Pearson’s correlation was0.96 between the Kujala and Oxford scores, 0.90 between the Larsen and Oxford scores, 0.94 between the Lysholm and Oxford score, and 0.93 between the Fulkerson and Oxford scores. Responsiveness, calculated by standardized response mean, was 1.2, and effect size was 1.4.ConclusionsThe Italian versions of the Kujala, Larsen, Lysholm and Fulkerson scoring systems were shown to be equivalent to their English versions and demonstrated good validity, reliability and responsiveness to surgical treatment of patellofemoral pathology. To the best of the authors’ knowledge, this is the first attempt to adapt four of the most common patellofemoral-specific scoring scales to the Italian language.Level of evidenceLevel II.Electronic supplementary materialThe online version of this article (10.1186/s10195-018-0508-9) contains supplementary material, which is available to authorized users.

Cross-Cultural Adaptation of the Greek Versions of the Lysholm Knee Scoring Scale and Tegner Activity Scale

“…Original and revised scores were intended for in-person clinician administration, although subsequent studies have documented using the score as a patient-completed questionnaire [2,10]. There are consistent reports of no floor or ceiling effects (i.e., <15% of patients scoring the lowest or highest score, respectively) [3,5,8,9]. Ra et al have reported no significant differences between the IKDC subjective and the LKSS in terms of the amount of ceiling effect and the correlation with one leg hope scale in patients with ACL reconstruction [23].…”

“…Activity levels of 6-10 can only be achieved if the person participates in recreational or competitive sport. Studies have consistently reported no floor or ceiling effects in those with a knee injury or osteoarthritis (OA) [3,5,8,12].…”

“…Floor and ceiling effects were also calculated and were considered to be present if more than 15% of the respondents achieved the lowest or highest possible total score [8]. In addition to the analysis of the Gr-LKSS and Gr-TAS total scores, the single items of the Gr-LKSS were analyzed identically for any floor or ceiling effects.…”

“…The TAS was developed as an additional instrument meant to complement the LKSS and designed to assess activity level based on work and sports activities. Both scores have been used in numerous publications worldwide, and their reliability, validity, and responsiveness have been established for various knee problems, including ACL and meniscal injuries [3,6,7], patellofemoral pain syndrome [8], medial patellar plica syndrome [9], patellar dislocation [10], various chondral disorders [11], knee arthroplasty [12], as well as in individuals with normal knees [13]. So far, both questionnaires have been translated, validated, and culturally adapted into several different languages, and they have all shown good internal consistency, test-retest reliability, and external validity [6,8,[11][12][13][14][15][16][17][18][19][20][21].…”

Efficacy and experience of arthroscopic lateral patella retinaculum releasing through/outside synovial membrane for the treatment of lateral patellar compression syndrome

“…Each patient was followed up by telephone or outpatient visit every month after surgery and every 3 months after 3 months after surgery. Lyshohn score (excellent: greater than 90 points, good: 80-90 points, better: 70-79 points, poor: less than 70 points), medial shift of patella, Kujala score, VAS, and surgical complications were used and evaluated for efficacy evaluation [6,[12][13][14][15].…”