Treatment outcomes of applying external fixator on distal radius fractures: a randomized clinical trial to compare between two directions of force exertion in parallel to radius shaft and perpendicular to the distal radius articular surface.

BACKGROUND: External fixation has been one of the conventional managements of unstable distal radius fracture. The main aim of this paper is to compare two methods of applying distractive force along the radius shaft versus perpendicular to the distal radius articular surface. DESIGN: Sixty patients with unstable distal radius fracture were included in present clinical trial and randomized in two groups, using block randomization method. In group A (first arm), distraction force was exerted parallel to the radius shaft. In group B (second arm), the external fixator was adjusted based on radial and palmar tilt of the mean population healthy wrist so that distraction was exerted perpendicular to the wrist articular surface. METHODS: Radiological and clinical parameters were evaluated in both groups of patients pre-operatively, immediately after surgery, and 6 weeks post-operatively. We also followed up patients clinically at 12 weeks after surgery. Patient-Rated Wrist Evaluation (PRWE), Mayo wrist score, and Quick Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires were used in order to assess patients' clinical and functional states. RESULTS: The method used in group B resulted in better improvement of palmar tilt both immediately (P = 0.007) and at 6 weeks follow up (P = 0.013) post-operatively in comparison with patients in group A. Radius height and radial inclination were also better restored when using the proposed modified method (P = 0.001 and < 0.001, respectively). There was no difference in any of clinical results (range of motion, grip strength, PRWE, Mayo, and DASH scores) between two groups of study, 12 weeks after surgery. CONCLUSION: Applying distractive force perpendicular to the distal radius articular surface seems to improve some radiological outcomes, probably due to better reduction maintenance, when compared with the technique of applying distraction force along distal radius shaft axis. LEVEL OF EVIDENCE: Level I (clinical trial study). TRIAL REGISTRATION: This study is registered at Iranian Registry of Clinical Trials (IRCT) with approval code of IRCT20200313046759N1.

Anthropometric Measurements of Distal Femur to Design the Femoral Component of Total Knee Arthroplasty for the Iranian Population.

BACKGROUND: Acquiring knowledge about anatomic and geometric quantities of bones is among the most vital parameters in orthopedic surgery that has a significant effect on the treatment of various disorders and subsequent outcomes. The aim of this study was to obtain anthropometric information for distal femur in order to compare with similar dimensions of prosthesis used in total knee arthroplasty (TKA) surgery and to design more suitable and optimal components. METHODS: Morphological data of distal femur were measured in 132 knees (81 males and 51 females) using magnetic resonance imaging (MRI). The data included anterior-posterior (AP) length, medial-lateral (ML) width, medial AP (MAP), lateral AP (LAP), MAP to LAP distance in the anterior distal femur namely anterior medial lateral (AML) width, medial and lateral condyle width, and intercondylar notch. The aspect ratio (ML/AP) was also calculated and the results were compared with similar dimensions of currently used knee implants. RESULTS: Our data showed that men are significantly larger in all dimensions than women. In the distal femur with similar AP lengths in both sexes, women had a smaller ML width than men (P<0.001). Comparison between the distal femur and studied prostheses showed no high correlation and similarity between the femoral component and femoral condyle prostheses in the resected surface of the bone. CONCLUSION: The results of this study can provide the data needed to design prostheses suitable for the Iranian population.

Correlation of Anthropometric Measurements of Proximal Tibia in Iranian Knees with Size of Current Tibial Implants.

BACKGROUND: The results of clinical studies have reported that Asian knee anatomical aspects are smaller than those of the Caucasian population. The purpose of this study was to investigate the morphometry of the proximal tibia in the standard resected surface of total knee arthroplasty (TKA). METHODS: In this descriptive study, the anthropometric data of the proximal tibia were measured in 132 knees (80 males and 52 females) using magnetic resonance imaging in 2015. The collected data included anteroposterior (AP) length, mediolateral (ML) width, medial AP, lateral AP, and aspect ratio (ML/AP). The medial and lateral AP distance to bone center was calculated for symmetry analysis. The morphometric data were also compared with the same dimensions of four current tibial implants. RESULTS: The mean age of the subjects was 38.26±11.45 year (age range: 20-60 years). The mean AP length and mean ML width in the resected surface of the bone, as well as the mean aspect ratio (ML/AP) of tibial bone in all the subjects, were 46.53±4.05 mm, 73.36±6.86 mm, and 1.58±0.11, respectively. The mean values of medial and lateral AP distance up to bone center were 13.40±6.17 and 17.09±6.83 mm, respectively, indicating asymmetric proximal tibia in the study population. CONCLUSION: The measurements of anatomic shapes and dimensions of the proximal tibia revealed that women have smaller dimensions than their male counterparts. Prostheses with smaller AP size tended to be undersized and larger AP size had a tendency towards overhang in the mediolateral dimension. The data and obtained results of this study can be used as guidance on designing tibial implant components suitable for TKA in the Iranian population.

Injury Patterns among Motorcyclist Trauma Patients: A Cross Sectional Study on 4200 Patients.

BACKGROUND: Motorcyclists are among the most vulnerable groups of road accident victims, who are prone to a growing mortality rate due to the constant rise in the number of accidents. This study was performed to investigate the injury patterns among motorcyclist trauma patients admitted to Kamyab Hospital, the largest trauma center affiliated with Mashhad Univercity of Medical Sciences, Mashhad, Iran, due to an accident. METHODS: This cross-sectional study was conducted on motorcyclists referred to our hospital due to accidents from August 23, 2014 to August 22, 2016 to receive treatment. After the accurate examination of the collected data and correction of the potential errors, they were subjected to analysis. The gathered data included the demographic variables, injury pattern, accident time, and accident type. Data analysis was performed in Stata Software, version 12. RESULTS: A total of 4,205 motorcycle accident cases were hospitalized (14% of all cases were hospitalized during the two-year study period). The mean age of the patients was 30 years, and 88% of them were male (a male to female ratio of 7.3). Car- and pedestrian-motorcycle collisions were the most common causes of injury that accounted for 68% and 22% of the cases, respectively. The head was the most commonly injured site of the body; in this regard, 59.7% of the admitted patients and 85.4% of total death cases had a head injury. In addition, 67% of the target population received trauma in more than two parts of their body. The elbow, arm, and hip were the least regions involved. CONCLUSION: Motorcycle accidents cause severe physical injuries to the patients' body. Head injury was the most common type of trauma, leading to a wide range of disabilities. Therefore, the use of crash helmets and avoidance of dangerous driving behaviors will remarkably decrease such trauma.

Hip Surgery in Quiescent or Active Tubercular Hip Arthritis; Is Reactivation Risk Really a Matter.

About 15 % of all musculoskeletal tuberculosis (TB) have hip involvement. Early anti-tubercular drug therapy and other conservative treatment including short-term traction and mobilization programs could prevent hip joint destruction. Reactivation of TB accounts for a significant of active TB incidence, especially in the developed countries with a low TB prevalence. The risk of TB activation for population with the latent form of disease is about 5-10%. According to the existing literature surgery in tubercular hip arthritis would be safe once sufficient debridement and precise anti tubercular chemotherapy has been done.

Translation and Cross-cultural Adaptation of the Hip Disability and Osteoarthritis Score into Persian Language: Reassessment of Validity and Reliability.

BACKGROUND: This study aimed Persian translation and validation of the hip disability and osteoarthritis outcome score (HOOS) questionnaire. METHODS: The study was carried out in two phases. First, we translated the HOOS according to acceptable guidelines. We assessed HOOS content convergent validity on 203 hip osteoarthritis patients using SF-36. Internal consistency was tested using Cronbach's alpha coefficient if each item removed and intraclass correlation coefficient (ICC) for the assessment of test-retest reproducibility. RESULTS: Patients had mean (standard deviation) age of 39 (17). Test-retest ICC in whole was 0.95 (P = 0.014) showing excellent reliability. ICC was 0.92 for the "pain" subscale (P = 0.02), 0.81 for the "symptom" subscale (P = 0.002), 0.81 for the "function of daily living (FDL)" (P = 0.022), 0.88 for the "function of sports and recreational activities" (P = 0.006), but it was 0.62 (P = 0.1) for the "quality of life (QOL)." Cronbach's alpha was 0.92, 0.73, 0.97, 0.86, 0.80, and 0.80 for the pain, symptom, FDL, function of sports, QOL, and stiffness, respectively, showing good to excellent internal consistancy. Having SF-36 for the assessment of convergent validity, there was a strong correlation between total HOOS score and the physical component summary domain of SF-36 (r = 0.64, P = 0.0001), whereas the t correlation with the mental component summary domain was weak (r = 0.16, P = 0.04). CONCLUSIONS: The Persian version of the HOOS questionnaire is a valid (regarding physical not mental aspects) and reliable assessment tool in patients with hip osteoarthritis.

Translation and Validation of the Persian Version the Boston Carpal Tunnel Syndrome Questionnaire.

BACKGROUND: Carpal tunnel syndrome (CTS) is recognized as the most common type of neuropathies. Questionnaires are the method of choice for evaluating patients with CTS. Boston Carpal Tunnel Syndrome (BCTS) is one of the most famous questionnaires that evaluate the functional and symptomatic aspects of CTS. This study was performed to evaluate the validity and reliability of the Persian version of BCTS questionnaire. METHODS: First, both parts of the original questionnaire (Symptom Severity Scale and Functional Status Scale) were translated into Persian by two expert translators. The translated questionnaire was revised after merging and confirmed by an orthopedic hand surgeon. The confirmed questionnaire was interpreted back into the original language (English) to check for any possible content inequality between the original questionnaire and its final translated version. The final Persian questionnaire was answered by 10 patients suffering from CTS to elucidate its comprehensibility; afterwards, it was filled by 142 participants along with the Persian version of the Quick-DASH questionnaire. After 2 to 6 days, the translated questionnaire was refilled by some of the previous patients who had not received any substantial medical treatment during that period. RESULTS: Among all 142 patients, 13.4 % were male and 86.6 % were female. The reliability of the questionnaire was tested using Cronbach's alpha and Intraclass correlation coefficient (ICC). Cronbach's alpha was 0.859 for symptom severity scale (SSS) and 0.878 for functional status scale (FSS). Also, ICCs were calculated as 0.538 for SSS and 0.773 for FSS. In addition, construct validity of SSS and FSS against QuickDASH were 0.641 and 0.701, respectively. CONCLUSION: Based on our results, the Persian version of the BCTQ is valid and reliable.Level of evidence: II.

Prognostic Factors Affecting the Results of Modified Thompson Quadricepsplasty for the Treatment of Extension Contracture of the Knee.

BACKGROUND: Knee extension contracture is a disabling complication after fractures around the knee. In this study we aimed to study factors influencing the outcomes of quadricepsplasty for the treatment of traumatic knee extension contracture. We hypothesized that there is no factor influencing the final range of knee motion. METHODS: In this retrospective study, we included 64 patients who underwent modified Thompson quadricepsplasty between 2008 to 2011 with a mean follow-up time of 36 months. RESULTS: The mean change in flexion was 66 degrees. Using Judet criteria, results were excellent in 41 patients (64%), good in 15 (23%), fair in 4 (6%) and poor in 4 (6%). Preoperative arc of flexion, duration of extension contracture, number of previous surgeries on the limb, and BMI of the patients were independently influencing the final flexion. CONCLUSION: Modified Thompson quadricepsplasty is associated with high number of excellent and good results especially when it is performed earlier in more severe contractures. Preoperative arc of flexion, interval between trauma surgery and quadricepsplasty, the number of prior surgeries, and BMI influence the outcomes of quadricepsplasty.

Measurement of Posterior Tibial Slope Using Magnetic Resonance Imaging.

BACKGROUND: Posterior tibial slope (PTS) is an important factor in the knee joint biomechanics and one of the bone features, which affects knee joint stability. Posterior tibial slope has impact on flexion gap, knee joint stability and posterior femoral rollback that are related to wide range of knee motion. During high tibial osteotomy and total knee arthroplasty (TKA) surgery, proper retaining the mechanical and anatomical axis is important. The aim of this study was to evaluate the value of posterior tibial slope in medial and lateral compartments of tibial plateau and to assess the relationship among the slope with age, gender and other variables of tibial plateau surface. METHODS: This descriptive study was conducted on 132 healthy knees (80 males and 52 females) with a mean age of 38.26±11.45 (20-60 years) at Imam Reza hospital in Mashhad, Iran. All patients, selected and enrolled for MRI in this study, were admitted for knee pain with uncertain clinical history. According to initial physical knee examinations the study subjects were reported healthy. RESULTS: The mean posterior tibial slope was 7.78± 2.48 degrees in the medial compartment and 6.85± 2.24 degrees in lateral compartment. No significant correlation was found between age and gender with posterior tibial slope (P≥0.05), but there was significant relationship among PTS with mediolateral width, plateau area and medial plateau. CONCLUSION: Comparison of different studies revealed that the PTS value in our study is different from other communities, which can be associated with genetic and racial factors. The results of our study are useful to PTS reconstruction in surgeries.

Psychometric Properties of the Persian Version of the Simple Shoulder Test (SST) Questionnaire.

BACKGROUND: To validate the Persian version of the simple shoulder test in patients with shoulder joint problems. METHODS: Following Beaton`s guideline, translation and back translation was conducted. We reached to a consensus on the Persian version of SST. To test the face validity in a pilot study, the Persian SST was administered to 20 individuals with shoulder joint conditions. We enrolled 148 consecutive patients with shoulder problem to fill the Persian SST, shoulder specific measure including Oxford shoulder score (OSS) and two general measures including DASH and SF-36. To measure the test-retest reliability, 42 patients were randomly asked to fill the Persian-SST for the second time after one week. Cronbach's alpha coefficient was used to demonstrate internal consistency over the 12 items of Persian-SST. RESULTS: ICC for the total questionnaire was 0.61 showing good and acceptable test-retest reliability. ICC for individual items ranged from 0.32 to 0.79. The total Cronbach's alpha was 0.84 showing good internal consistency over the 12 items of the Persian-SST. Validity testing showed strong correlation between SST and OSS and DASH. The correlation with OSS was positive while with DASH scores was negative. The correlation was also good to strong with all physical and most mental subscales of the SF-36. Correlation coefficient was higher with DASH and OSS in compare to SF-36. CONCLUSION: Persian version of SST found to be valid and reliable instrument for shoulder joint pain and function assessment in Iranian population.

Total Ankylosis of the Upper Left Limb: A Case of Progressive Osseous Heteroplasia.

Progressive osseous heteroplasia is a rare inherited disease that begins with skin ossification and proceeds into the deeper connective tissues. The disease should be distinguished from other genetic disorders of heterotopic ossification including fibrodysplasia ossificans progressiva (FOP) and Albright hereditary osteodystrophy (AHO). We report a case of progressive osseous heteroplasia in a twenty four years old male with a complaint of ankylosis of the entire upper left limb and digital cutaneous lesions and sparing of the other limbs and the axial skeleton. Absence of great toe malformation, presence of cutaneous ossification, dermal bone spicules extruding in fingers, and involvement of just left upper limb were unique findings in contrast with FOP diagnosis in this case. There is no effective treatment or prevention for POH. Awareness of diagnostic features is necessary in early diagnosis of POH.

Cross-Cultural Adaptation, Validation, and Reliability Testing of the Modified Oswestry Disability Questionnaire in Persian Population with Low Back Pain.

STUDY DESIGN: Prospective study. PURPOSE: We aimed to validate the Persian version of the modified Oswestry disability questionnaire (MODQ) in patients with low back pain. OVERVIEW OF LITERATURE: Modified Oswestry low back pain disability questionnaire is a well-known condition-specific outcome measure that helps quantify disability in patients with lumbar syndromes. METHODS: To test the validity in a pilot study, the Persian MODQ was administered to 25 individuals with low back pain. We then enrolled 200 consecutive patients with low back pain to fill the Persian MODQ as well as the short form 36 (SF-36) questionnaire. Convergent validity of the MODQ was tested using the Spearman's correlation coefficient between the MODQ and SF-36 subscales. Intraclass correlation coefficient (ICC) and Cronbach's α coefficient were measured to test the reliability between test and retest and internal consistency of all items, respectively. RESULTS: ICC for individual items ranged from 0.43 to 0.80 showing good reliability and reproducibility of each individual item. Cronbach's α coefficient was 0.69 showing good internal consistency across all 10 items of the Persian MODQ. Total MODQ score showed moderate to strong correlation with the eight subscales and the two domains of the SF-36. The highest correlation was between the MODQ and the physical functioning subscale of the SF-36 (r=-0.54, p<0.001) and the physical component domain of the SF-36 (r=-0.55, p<0.001) showing that MODQ is measuring what it is supposed to measure in terms of disability and physical function. CONCLUSIONS: Persian version of the MODQ is a valid and reliable tool for the assessment of the disability following low back pain.

Oxford Shoulder Score: A Cross-Cultural Adaptation and Validation Study of the Persian Version in Iran.

BACKGROUND: Oxford shoulder score is a specific 12-item patient-reported tool for evaluation of patients with inflammatory and degenerative disorders of the shoulder. Since its introduction, it has been translated and culturally adapted in some Western and Eastern countries. The aim of this study was to translate the Oxford Shoulder Score (OSS) in Persian and to test its validity and reliability in Persian speaking population in Iran. METHODS: One hundred patients with degenerative or inflammatory shoulder problem participated in the survey in 2012. All patients completed the Persian version of OSS, Persian DASH and the SF-36 for testing validity. Randomly, 37 patients filled out the Persian OSS again three days after the initial visit to assess the reliability of the questionnaire. RESULTS: Cronbach's alpha coefficient was 0.93. The intraclass correlation coefficient was 0.93. In terms of validity, there was a significant correlation between the Persian OSS and DASH and SF-36 scores (P < 0.001). CONCLUSION: The Persian version of the OSS proved to be a valid, reliable, and reproducible tool as demonstrated by high Cronbach's alpha and Pearson's correlation coefficients. The Persian transcript of OSS is administrable to Persian speaking patients with shoulder condition and it is understandable by them.

Translation and cultural adaptation of the Manchester-Oxford Foot Questionnaire (MOXFQ) into Persian language.

PURPOSE: In this study, we aimed to translate and test the validity and reliablity of the Persian version of the Manchester-Oxford Foot Questionnaire in foot and ankle patients. METHODS: We translated the Manchester-Oxford Foot Questionnaire to Persian language according to the accepted guidelines, then assessed the psychometric properties including the validity and reliability on 308 patients with long-standing foot and ankle problems. To test the reliability, we calculated the intra-class correlation coefficient (ICC) for test-retest reliability and measured Cronbach's alpha to test the internal consistency. To test the construct validity of the Manchester-Oxford Foot Questionnaire we also administered the Short-Form 36 to patients. RESULTS: Construct validity was supported by significant correlation with SF36 subscales except for pain subscale of the persian MOXFQ with mental health of the SF36 (r=0.207). Intraclass correlation coefficient was 0.79 for the total MOXFQ and ranged from 0.83 to 0.89 for the three subscales. Cronbach's alpha for pain, walking/standing, and social interaction was 0.86, 0.88, and 0.89, respectively, and was 0.79 for the total MOXFQ showing good internal consistency in each domain. CONCLUSION: The Persian Manchester-Oxford Foot Questionnaire health scoring system is a valid and reliable patient-reported instrument for foot and ankle problems.

Validity and Reliability of the Persian Version of Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire (Quick-DASH).

BACKGROUND: The aim was to assess the validity and reliability of the Persian version of shortened disabilities of the arm, shoulder, and hand (Quick-DASH) questionnaire in patients with upper extremity conditions. METHODS: We administered the Persian version of Quick-DASH to 202 patients with upper extremity conditions, of which 71 patients randomly returned after 3 days to respond to the questionnaire for the 2(nd) time. In order to test the construct validity of the questionnaire, patients responded to the Michigan Hand Outcome Questionnaire (MHOQ) and Short Form 36 Health Survey (SF-36) as well. Internal consistency was tested using the Cronbach's alpha, and test-retest reliability was measured using intra-class correlation coefficient (ICC). RESULTS: Cronbach's alpha was 0.90. ICC was 0.89. Convergent validity was confirmed, as the Spearman correlation between the Quick-DASH and MHOQ was 0.67 and ranged from 0.24 to 0.56 between the subscales of the SF-36 and Quick-DASH. CONCLUSIONS: Observation of excellent internal consistency, good to excellent test-retest reliability, and moderate to strong construct validity confirms the validity and reliability of the Persian version of Quick-DASH for evaluating the magnitude and level of disability in upper extremity conditions.

Clinical instability of the knee and functional differences following tibial plateau fractures versus distal femoral fractures.

BACKGROUND: Fractures of the knee account for about 6% of all trauma admissions. While its management is mostly focused on fracture treatment, it is not the only factor that defines the final outcome. OBJECTIVES: This study aimed to study objective and subjective outcomes after proximal tibial versus distal femoral fractures in terms of knee instability and health-related quality of life. PATIENTS AND METHODS: This retrospective, cross-sectional, cohort study was carried out on 80 patients with either isolated proximal tibial (n = 42) or distal femoral (n = 38) fractures, who underwent open reduction and internal fixation. All the fractures were classified based on the Schatzker and AO classification for tibial plateau and distal femoral fractures, respectively. The patients were followed and examined by an orthopedic knee surgeon for clinical assessment of knee instability. In their last follow-up visit, these patients completed a Lysholm knee score and the short-form (SF) 36 health survey. RESULTS: Among the 42 tibial plateau fractures, 25% were classified as Schatzker type 2. Of the 38 distal femoral fractures, we did not find any type B1 or B3 fractures. The overall prevalence of anterior and posterior instability was 42% and 20%, respectively. Medial Collateral Ligament (MCL) and Lateral Collateral Ligament (LCL) injuries were detected clinically in 50% and 28%, respectively. The incidence rates of ligament injuries in tibial plateau fractures were as follows: Anterior Collateral Ligament (ACL) 26%, Posterior Collateral Ligament (PCL) 7%, MCL 24%, and LCL 14%. Medial collateral ligament injury was the most common in the Schatzker type 2 (50% of the injuries). Distal femoral fractures were associated with ACL injury in 16%, PCL in 13%, MCL in 26% and LCL in 14%. However, final knee range of motion (ROM) and function (Lysholm score) were not associated with fracture location. No statistically significant difference was observed between the two groups, except for the valgus stress test at 30°knee flexion, which was more positive in tibial fractures. All eight domains of SF-36 score in the distal femoral and proximal tibial fractures were significantly different from the normal values; however, there were no statistically significant differences between femoral and tibial fracture scores. CONCLUSIONS: Although ROM is acceptable in knee joint fractures, instability is common. However, it seems that knee function and quality of life are not associated with the location of the fracture.

Cross-cultural adaptation, validation, and reliability of the Michigan Hand Outcomes Questionnaire among Persian population.

We aimed to validate a cross-culturally adapted version of the Persian Michigan Hand Outcomes Questionnaire (MHOQ). We followed the Beaton's guideline to translate the questionnaire to Persian. We administered the final version to 223 patients among which 79 patients returned 3 days later to respond to the Persian MHOQ for the second time. In the first visit, respondents also filled the Disabilities of the Arm Shoulder and Hand (DASH) and rated the pain based on the Visual Analogue Scale (VAS). Cronbach's alpha for the total MHOQ was 0.79 which showed good internal consistency. Intraclass correlation coefficient (ICC) for the total MHOQ was 0.84 which demonstrated good reliability between test and retest. The absolute correlation coefficient between total MHOQ and the DASH was as high as 0.74. Persian version of the MHOQ proved to be a reliable and valid instrument to be implemented among Persian population with the hand and wrist disorders.

Cross-cultural adaptation, validation, and reliability testing of the Shoulder Pain and Disability Index in the Persian population with shoulder problems.

UNLABELLED: We aimed to validate the translated and cross-culturally adapted Persian version of the Shoulder Pain and Disability Index (SPADI). The final Persian SPADI was administered to 190 patients, out of whom 83 patients returned for the retest. We administered the Persian version of the SF-36 quality-of-life inventory and the disabilities of the arm shoulder and hand (DASH) questionnaires at the first visit to assess the convergent validity. Cronbach's α was 0.94 for the total SPADI, which showed excellent internal consistency. The intraclass correlation coefficient was 0.84 for the total SPADI, which showed good reliability between the test and retest. Convergent validity was confirmed, as the Spearman correlation between total SPADI and DASH was 0.61. Moreover, there was significant correlation between the subscales of the SPADI and SF-36 scales. The Persian version of the SPADI proved to be a reliable and valid instrument to be implemented in the Persian population with shoulder disorders. LEVEL OF EVIDENCE: level II.

The International Knee Documentation Committee (IKDC) Subjective Short Form: a validity and reliability study.

PURPOSE: The purpose of the present research was to translate the original English version of International Knee Documentation Committee (IKDC) Subjective Short Form to Persian and to assess validity and reliability of it in Iranian patients with ACL injury. METHOD: The Persian version of the IKDC Subjective Short Form was administered to 145 patients including 111 men (76 %) and 34 women (24 %) with the clinical diagnosis of knee ACL tear that were referred to our Knee and Shoulder Center at Mashhad University of Medical Sciences, Mashhad, Iran. The Persian IKDC Subjective Short Form and Persian SF-36 questionnaire were completed by patients in the clinic before beginning any treatment intervention. Patients filled out the Persian IKDC 72 h again before receiving a major treatment; we were then able to use the test-retest method to calculate reliability. RESULTS: The average age of the subjects was 30.9 ± 10.4 years. The calculated ICC with 95 % confidence interval was 0.845. In this study, Cronbach's alpha was 0.845. There were significant correlations between mean total score of the Persian IKDC and all items of the SF36 (P < 0.05) except for MCS (P = 0.055). CONCLUSION: Cronbach's alpha and correlation of IKDC Subjective Short Form and SF-36 demonstrated that the Persian version of IKDC has both strong reliability and validity. The Iranian version of IKDC has favourable validity and reliability and therefore can be used to assess Persian-speaking patients with cruciate ligament injuries. LEVEL OF EVIDENCE: Level II.

Cross-cultural adaptation and validation of the persian version of the oxford knee score in patients with knee osteoarthritis.

BACKGROUND: The Oxford Knee Score (OKS) is a short patient-reported outcome instrument that measures pain and physical activity related to knee osteoarthritis. The purpose of this study is to evaluate, construct validity and consistent reliability of the Persian version of the OKS. METHODS: The case series consisted of 80 patients who were clinically diagnosed with having knee osteoarthritis. All patients were requested to fill-in the Persian OKS and Short-Form 36 Health Survey (SF-36). Correlation analysis between the Persian versions of these two instruments was then carried out. The scores of the Persian SF-36 were used to evaluate convergent and divergent validity of the 12-item Persian OKS. RESULTS: From a total of 80 patients, 63 were female (79%) and the remaining 17 were male (21%) with a mean age of 52.2 years. In the present study, high Cronbach's alpha of 0.95 confirms excellent internal consistency of the Persian OKS scale similar to previous investigations. The results confirm that the Persian version of this instrument is valid and reliable, similar to its English index and its subsequent translations in different languages. CONCLUSION: The Persian OKS is a reliable instrument to evaluate knee function in patients with knee osteoarthritis and is a useful tool for outcome measurement in clinical research.