ArticleKnee surgery & related research2026
Cross-cultural adaptation and psychometric validation of the first Arabic KOOS-12: a reliable tool for assessing knee outcomes in Arabic-speaking populations.
Article in Knee surgery & related research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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- Duloxetine for postoperative pain management in total hip and knee arthroplasty: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2026Pooled it
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7 authors.
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Abstract
backgroundThe Knee injury and Osteoarthritis Outcome Score-12 (KOOS-12) is a widely used patient-reported outcome measure assessing pain, function, and quality of life (QOL) in individuals with knee osteoarthritis or injury. However, the absence of validated short-form knee instruments in Arabic necessitates cross-cultural adaptation.
methodsA prospective cross-sectional validation of the Arabic KOOS-12 (KOOS-12 AR) was conducted following established guidelines for translation and adaptation (independent forward translations, reconciliation, blinded back-translation, expert review, pilot testing, and proofreading). Adults > 40 years with knee osteoarthritis were consecutively recruited from two outpatient clinics and completed the KOOS-12 AR and the validated Arabic WOMAC (WOMAC-AR). A total of 201 patients were enrolled, and a clinically stable subset of 91 participants (the retest subgroup) completed a retest after 5-10 days. Psychometric evaluation included interpretability, internal consistency (Cronbach's α), test-retest reliability using intraclass correlation coefficients (ICC(2,1)), and measurement error indices such as standard error of measurement (SEM), minimal detectable change (MDC), and content, structural, and convergent validity.
resultsInternal consistency was excellent across domains (Cronbach's α = 0.93). Test-retest reliability was likewise excellent (ICC(2,1) = 0.990 for Pain, 0.992 for Function, 0.989 for QOL, and 0.987 for the Total score). SEM values were small (2.1-2.3 points), yielding MDC_individual ≈6 points across subscales. Bland-Altman analyses showed minimal bias (-0.36 to -0.02) and narrow limits of agreement (approximately ± 6-7 points). Structural validity was supported by principal component analysis (PCA): each subscale demonstrated a clear one-factor solution (Pain eigenvalue 2.50, 62.5% variance; Function 2.72, 67.9%; QOL 2.48, 62.1%). When all 12 items were analyzed together, the dominant first component explained 50.6% of total variance (Kaiser-Meyer-Olkin (KMO) = 0.91). Convergent validity with WOMAC-AR was strong, with Spearman's ρ = 0.879 for total scores (p < 0.0001).
conclusionThe KOOS-12 AR demonstrated excellent reliability, validity, structural coherence, and measurement reproducibility. It represents a robust, culturally appropriate, and feasible instrument for evaluating knee pain, function, and QOL among Arabic-speaking patients.
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