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Background: The modified Harris Hip Score (mHHS) is one of the more commonly used patient-reported outcome measures to evaluate and monitor treatment in patients with hip abnormalities and has been translated into several languages. Purpose: To develop a Thai version of the mHHS (TH-mHHS) and evaluate the validity and reliability of the measure. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: The TH-mHHS was developed using the forward-backward translation method. Patients who presented with hip pain during the first clinic visit completed the Thai version of questionnaires including the mHHS, 36-item Short Form Health Survey (TH-SF36), and Hip disability and Osteoarthritis Outcome Score (TH-HOOS). The validity between the measures was tested using the Spearman correlation coefficient. The test-retest reliability of the TH-mHHS was assessed using the intraclass correlation coefficient, and internal consistency was assessed using the Cronbach alpha. Results: A total of 64 patients were enrolled who had a mean age of 52.8 ± 16.6 years (range, 17-80 years). There were 64% female and 36% male participants. The TH-mHHS showed a moderate correlation with all subscales of the TH-HOOS and the total TH-HOOS (r = 0.50-0.65; P < .01) and a high correlation with the physical functioning subscale and physical component summary of the TH-SF36 (r = 0.73 and 0.75, respectively; P < .01). The test-retest reliability was excellent, with an intraclass correlation coefficient of 0.95 (95% CI, 0.92-0.97; P < .001). The internal consistency was acceptable, with a Cronbach alpha of .71. No floor or ceiling effects were observed. Conclusion: The TH-mHHS showed a moderate to high correlation with the TH-SF36 and TH-HOOS, excellent test-retest reliability, and acceptable internal consistency. This measure can be effectively used for evaluating Thai patients with hip disorders, especially an older and arthritic population.
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Arthroscopic treatment is the treatment of choice in bucket-handle meniscal tears (BHMTs). Following BHMT, however, surgery failure rates are approximately 20% in the literature. Achieving the healing of BHMT is difficult. This is worse in chronic situations because the torn meniscus is deformed, leading to nonanatomical reduction. Some authors have reported greater failure rates, especially in the early postoperative period. In isolated BHMTs, the failure rate is greater because of inadequate and incomplete repairs due to the tight medial compartment. Multiple techniques for possible reduction of failure rate have been described. We describe an arthroscopic technique for treating chronic isolated BHMT using the technique of subcutaneously releasing the posterior fibers of the medial collateral ligament to provide adequate space for arthroscopy, meniscal reduction, and repair. A combined inside-out and all-inside repair technique was used to enhance anatomic reduction, stable fixation, surface fixation (rather than the usual suture-points fixation), and biologic healing in repairable chronic BHMTs.
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OBJECTIVE: Subacromial impingement syndrome is one of the most common causes of pain in the shoulder. To this date, there is no specific radiographic view that can be used to evaluate the size of a subacromial spur. This study aims to examine a cassette tilt view can be used to evaluate the size of a subacromial spur. METHODS: A cross-sectional study was conducted between the time period of January 1, 2016, and December 31, 2016. Forty-three consecutive patients that had planned treatment of arthroscopic subacromial decompression (SAD) participated in this study. Rockwood view and cassette tilt view (caudal tilt 30 with beam and cassette) X-rays were done in all these patients. The measurements of the spur sizes were calculated from both views and were compared to the spur sizes measured intraoperatively. RESULT: The size of the spurs from intraoperative measurement was not significantly different from the spur size measured using the cassette tilt view with a mean difference of 0.54 (95% confidence interval (CI): - 0.58, 1.65), but the intraoperative measurement was significantly different from the Rockwood view spur measurement, with a mean difference of 2.84 (95% CI: 1.56, 4.11). Average proportions of the size of the spur from the cassette tilt and Rockwood view compared to that from intraoperative measurements were 1.09 and 1.55, respectively. CONCLUSION: The cassette tilt view is a simple method of measurement of the size of subacromial spurs, with good inter- and intra-observer reliabilities and good validity. This can be useful clinically when setting the patient position and portals to evaluate the size of the spur when planning SAD. LEVEL OF EVIDENCE: This is level III.
