Knee Injury and Osteoarthritis Outcome Score for Tibial Shaft Fractures: Validity, Reliability, Responsiveness, and Minimal Clinically Important Difference.
Rasmus Stokholm, Peter Larsen, Juozas Petruskevicius, Jan Duedal Rölfing, Morten Kjerri Rasmussen, Steffen Skov Jensen, Rasmus Elsoe
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Abstract
Background: This study evaluated the relevance, construct validity, test-retest reliability, and responsiveness and estimate the minimal clinically important difference in the Knee Injury Osteoarthritis outcome score (KOOS) for patients with tibial shaft fractures.
Materials and methods: This prospective cohort study included adult patients who were surgically treated after tibial shaft fracture (AO 42-). The primary outcome measure was the score on the KOOS subscales of pain, symptoms, activities of daily living, sport and recreational activities, and knee-related quality of life. Scores were obtained at 14 days, 15 days, 6 weeks, and 3, 6, and 12 months postoperatively. Relevance was evaluated by patients' ranking all KOOS items; construct validity was evaluated by comparing KOOS scores with the Health-Related Quality of Life questionnaire; test-retest reliability was evaluated by comparing KOOS scores over a 24-hour period; and responsiveness was evaluated based on predefined hypotheses and effect size.
Results: Sixty patients (mean age, 47.1 years; range, 18-84 years) were included. Results showed acceptable relevance and construct validity for all KOOS subscales. Test-retest reliability was high for all 5 subscales, with an intraclass correlation coefficient of 0.9. Responsiveness was observed with moderate to high correlations (r≥0.3) for the predefined hypotheses and moderate to large effect sizes, ranging from 0.5 to 1.3, for the subscales of pain, activities of daily living, symptoms, and sport and recreational activities.
Conclusion: The KOOS showed acceptable relevance, construct validity, and responsiveness and moderate to high test-retest reliability for patients with tibial shaft fractures. Further validation of the psychometric properties of the KOOS for tibial shaft fractures may expand its usefulness for this patient group. [Orthopedics. 2025;48(3):146-152.].
期刊介绍：
For over 40 years, Orthopedics, a bimonthly peer-reviewed journal, has been the preferred choice of orthopedic surgeons for clinically relevant information on all aspects of adult and pediatric orthopedic surgery and treatment. Edited by Robert D''Ambrosia, MD, Chairman of the Department of Orthopedics at the University of Colorado, Denver, and former President of the American Academy of Orthopaedic Surgeons, as well as an Editorial Board of over 100 international orthopedists, Orthopedics is the source to turn to for guidance in your practice.
The journal offers access to current articles, as well as several years of archived content. Highlights also include Blue Ribbon articles published full text in print and online, as well as Tips & Techniques posted with every issue.
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