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Background: The Anterior Cruciate Ligament-Quality of Life (ACL-QoL) questionnaire is a valid and reliable injury-specific instrument to assess the impact of an ACL rupture on the daily life of a patient. Purpose: To translate the ACL-QoL into Dutch (ACL-QoL-NL) and to study its psychometric properties in patients with an ACL rupture. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: The original ACL-QoL questionnaire was translated from English to Dutch according to international guidelines. The study population consisted of 122 patients with a confirmed ACL rupture who completed the ACL-QoL-NL as well as 4 questionnaires: the International Knee Documentation Committee subjective score, Knee injury and Osteoarthritis Outcome Score, 36-item Short Form Health Survey, and Lysholm Knee Score. We determined the internal consistency, construct validity, and prevalence of floor and ceiling effects of the ACL-QoL-NL total score as well as its 5 subscales. To determine test-retest reliability, we analyzed the data of 68 patients who had a stable knee condition and who completed the ACL-QoL-NL a second time after a 2-week interval. Results: The confirmatory factor analysis showed that the original structure of the ACL-QoL-NL was confirmed, except for 4 of 31 items. Internal consistency of the total scale and all 5 subscales was good. More than 75% of the predefined hypotheses on the correlations between the ACL-QoL-NL and the 4 questionnaires were met, indicating good construct validity. No significant floor or ceiling effects were observed. Test-retest reliability was good, and no systematic bias between test and retest was found. Standard error of measurement for the total score was 4.8 points out of 100, and the smallest detectable changes at the group and individual levels were 1.6 and 13.2 points, respectively. Conclusion: The ACL-QoL-NL questionnaire was successfully translated from English to Dutch and demonstrated good internal consistency, validity, and reliability, with no presence of floor or ceiling effects.
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BACKGROUND: There has been renewed interest in the concept of anterior cruciate ligament (ACL) suture repair (ACLSR). Morphologic characteristics of the ruptured ACL remnant play a role in deciding whether a patient is eligible for ACLSR. However, no classification of these characteristics of ACL rupture on magnetic resonance imaging (MRI) scans has yet been compared with intraoperative findings in the context of ACLSR. PURPOSE: To investigate the value of using preoperative MRI to predict specific characteristics of acute complete ACL rupture. STUDY DESIGN: Cohort study (diagnostic); Level of evidence, 2. METHODS: A total of 25 patients were included. Two radiologists classified ACL rupture location and pattern on preoperative 1.5-T MRI scans with a standard sequence; the results were compared with the corresponding findings at arthroscopy conducted by a single surgeon. The agreement between the MRI and surgical findings was calculated using Cohen κ values. Furthermore, the reliability coefficients of the MRI classifications within and between radiologists were calculated. RESULTS: The agreement between MRI classification and arthroscopic findings for ACL rupture location was slight (Cohen κ, 0.016 [radiologist 1] and 0.087 [radiologist 2]), and for ACL rupture pattern, this was poor to slight (Cohen κ, <0 and 0.074). The intraobserver reliability of MRI classification for ACL rupture location was moderate for radiologist 1 and slight for radiologist 2 (Cohen κ, 0.526 and 0.061, respectively), and for ACL rupture pattern, this was slight for radiologist 1 and 2 (Cohen κ, 0.051 and 0.093, respectively). The interobserver reliability of MRI classification for ACL rupture location and pattern was slight between radiologists (Cohen κ, 0.172 and 0.040, respectively). CONCLUSION: In the current study, we found poor to slight agreement between MRI classification and arthroscopic findings of specific ACL rupture characteristics. In addition, the intra- and interobserver reliability for MRI classification of the ACL rupture characteristics was slight to moderate.
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OBJECTIVE: This study aims to investigate whether patients' perceptions regarding a Web-based telemedicine service, for instruction and monitoring of an exercise program, change after brief use. MATERIALS AND METHODS: Thirty patients were allocated, matched on gender and age, to a control group (10) or an experimental group (20). After basic training, the experimental group was given a 15 min opportunity to use a Web-based telemedicine service. Patients' perceptions regarding the telemedicine service were measured using a questionnaire, based on the Technology Acceptance Model (TAM). This questionnaire was administered to both the control and experimental group before and after the experimental group's intervention. Both groups were compared with respect to any change in perceptions related to the Web-based telemedicine service. RESULTS: The experimental group showed a significantly greater change on the TAM constructs perceived usefulness [F(1,27)=3.40, p =0.08] and perceived ease of use [F(1,27)=5.37, p=0.03] than the control group, who showed no statistically significant change of perceptions. Patients within the experimental group became significantly more positive about the usefulness and ease-of-use of the Web-based telemedicine program after a brief period of use. CONCLUSIONS: These findings show that brief use of a Web-based telemedicine service has a significant positive effect on patients' perceptions of this service. Therefore, as patients do not have prior experience with innovative telemedicine services, offering patients a risk-free way to explore and experiment with the service can increase the development of accurate perceptions and user needs. Ultimately, this will increase patients' acceptance of telemedicine. Future studies should investigate the effect of continued usage on patients' perceptions of telemedicine.
