Elbow
Jetske Viveen; Matthijs P. Somford; Koen L.M. Koenraadt; Michel P. J. van den Bekerom; Denise Eygendaal; Inger B. Schipper; Job N. Doornberg
Volume 7, Issue 2 , March and April 2019, , Pages 191-198
Abstract
The use of eponymous terms in orthopedic trauma surgery is common. In an assessment pre-training versus posttrainingat an AO Advanced Elbow Trauma Course, we aimed to report on (1) the accuracy and (2) reliability of 10common eponymous terms used for surgical approaches and fractures in elbow surgery. ...
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The use of eponymous terms in orthopedic trauma surgery is common. In an assessment pre-training versus posttrainingat an AO Advanced Elbow Trauma Course, we aimed to report on (1) the accuracy and (2) reliability of 10common eponymous terms used for surgical approaches and fractures in elbow surgery. Before training, eponymswere described correctly in 38% of questions versus 47% after training. The percentage of correct answers onlyimproved significantly in one question (P<0.005). A generalized kappa of 0.37 before training versus 0.31 aftertraining represents an overall fair reliability of the eponymous terms. In conclusion, the accuracy and reliabilityof eponymous terms used in elbow surgery is disappointing. Moreover, this type of standardized training formatdoes not seem to improve the knowledge of eponymous terms of experienced trauma- and orthopedic surgeons.Therefore, we suggest considering descriptive terms or standardized fracture classifications instead of eponymousterms.Level of evidence: II
Spine
Afshin Ahmadzadeh Heshmati; Moghaddameh Mirzai
Volume 6, Issue 2 , March 2018, , Pages 119-123
Abstract
Background: The purpose of this study was validation of the Persian translation of the Swiss Spinal StenosisQuestionnaire in order to be used by Iranian researchers.Methods: A total of 104 patients with spinal stenosis diagnosis, who were candidates for operative treatment wereentered into the study. ...
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Background: The purpose of this study was validation of the Persian translation of the Swiss Spinal StenosisQuestionnaire in order to be used by Iranian researchers.Methods: A total of 104 patients with spinal stenosis diagnosis, who were candidates for operative treatment wereentered into the study. The patients completed the translated questionnaire in the 1st and the 7th days of admissionand 6 months after surgery. Visual analogue scale was used to determine the severity of the pain in the1st day andthe 6th month. Discriminant validity, convergent validity, test-retest reliability, internal consistency, ability to detectchanges and sensitivity to clinical changes were assessed for the statistical purposes.Results: Cronbach’s α was more than 0.9 for all the items. ICC was about 0.9 for all the items. For symptoms, physical andtotal items, Cronbach’s α was 0.942, 0.957, 0.926 and Intraclass correlation were 0.891, 0.918, 0.862, respectively. Pairedt-test was significantly different between the 1st day and the 6th month questionnaire. There was a positive correlation eitherbetween the first VAS and the 1st day questionnaire (1st day Q) (r=0.892, P=0.000) or between the 6th month VAS and 6thmonth Q (r=0.940, P=0.000). The Pearson’s correlation between the difference of the total scores of the 1st day and the6th month and satisfaction score after surgery showed negative correlation (r= -0.746, P=0.000). The effect size was 2.55.Conclusion: The Iranian version of the Swiss Spinal Stenosis has excellent internal consistency, excellent reliability,good ability to alter with changes, especially parallel with clinical improvement, excellent ability to detect changes, andwell either convergent or discriminant validity.
Knee
Omid Yazdanpanah; Mahmoud Karimi Mobarakeh; Masoud Nakhaei; Mohammad R. Baneshi
Volume 5, Issue 3 , May 2017, , Pages 174-180
Abstract
Background: Knee malalignment is an important modifiable cause of osteoarthritis (OA). Surgical therapeutic procedures depend on proper knee alignment assessment. The purpose of this study was to compare knee alignment parameters between double and single leg weight-bearing radiographs and to ...
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Background: Knee malalignment is an important modifiable cause of osteoarthritis (OA). Surgical therapeutic procedures depend on proper knee alignment assessment. The purpose of this study was to compare knee alignment parameters between double and single leg weight-bearing radiographs and to evaluate the reproducibility of inter- and intra-observer measurements. Methods: One hundred eight patients (59 male and 49 female) with knee deformity visited at Kerman Knee Clinic were selected. Full limb anteroposterior (AP) Radiographs were taken for each participant in double and single leg weight-bearing positions. Hip-Knee-Ankle Angle (HKAA), Medial-Proximal-Tibial Angle (MPTA), Lateral-Distal-Femoral Angle (LDFA) and Joint-Line-Convergence Angle (JLCA) measured. Images stored on PC were examined by three observers to assess inter and intra observer reproducibility. Data analysis was done by SPSS software. Results: The mean age of patients was 48.4 (±6.84) years, mean BMI was 26.55 (±1.94) Kg/m2. The mean HKAA and JLCA were significantly different between double and single leg weight-bearing radiographs. Intraclass correlation coefficient (ICC) test showed high (0.99) inter-reproducibility between three observers in all cases, except one (ICC=0.92). Intra-observer reproducibility indicated a strong correlation between the observer’s measurements at different times (ICC > 0.99). Conclusion: HKAA and JLCA were affected by the patient’s position. Observer and time interval had no effect on either of HKAA, MPTA, LDFA, and JLCA. Also the measurement of knee alignment parameters was not dependent on observer’s experience. In conclusion single leg weight-bearing radiography is more representative of knee alignment and is inter and intra-observer reproducible.
Shoulder
Mohammad H. Ebrahimzadeh; Ehsan Vahedi; Aslan Baradaran; Ali Birjandinejad; Seyyed-Hadi Seyyed-Hoseinian; Farshid Bagheri; Amir R. Kachooei
Volume 4, Issue 4 , October 2016, , Pages 387-392
Abstract
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 ...
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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.
Trauma
Ydo V. Kleinlugtenbelt; Vanessa A.B. Scholtes; Jay Toor; Christian Amaechi; Mario Maas; Mohit Bhandari; Rudolf W. Poolman; Peter Kloen
Volume 4, Issue 4 , October 2016, , Pages 337-342
Abstract
Background: The purpose of this study was to determine whether Multi-Detector Computed Tomography (MDCT) in addition to plain radiographs influences radiologists’ and orthopedic surgeons’ diagnosis and treatment plans for delayed unions and non-unions. Methods: A retrospective ...
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Background: The purpose of this study was to determine whether Multi-Detector Computed Tomography (MDCT) in addition to plain radiographs influences radiologists’ and orthopedic surgeons’ diagnosis and treatment plans for delayed unions and non-unions. Methods: A retrospective database of 32 non-unions was reviewed by 20 observers. On a scale of 1 to 5, observers rated on X-Ray and a subsequent Multi Detector Helical Computer Tomography (MDCT) scan was performed to determine the following categories: "healed", "bridging callus present", "persistent fracture line" or "surgery advised". Interobserver reliability in each category was calculated using the Interclass Correlation Coefficient (ICC). The influence of the MDCT scan on the raters’ observations was determined in each case by subtracting the two scores of both time points. Results: All four categories show fair interobserver reliability when using plain radiographs. MDCT showed no improvement, the reliability was poor for the categories "bridging callus present" and "persistent fracture line", and fair for "healed" and "surgery advised". In none of the cases, MDCT led to a change of management from nonoperative to operative treatment or vice versa. For 18 out of 32 cases, the treatment plans did not alter. In seven cases MDCT led to operative treatment while on X-ray the treatment plan was undecided. Conclusion: In this study, the interobserver reliability of MDCT scan is not greater than conventional radiographs for determining non-union. However, a MDCT scan did lead to a more invasive approach in equivocal cases. Therefore a MDCT is only recommended for making treatment strategies in those cases.
Fatih Küçükdurmaz; Miguel Gomez; Eric Secrist; Javad Parvizi
Volume 3, Issue 3 , July 2015, , Pages 163-168
Abstract
Background: The Internet has become the most widely-used source for patients seeking information more about their health and many sites geared towards this audience have gained widespread use in recent years. Additionally, many healthcare institutions publish their own patient-education web sites with ...
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Background: The Internet has become the most widely-used source for patients seeking information more about their health and many sites geared towards this audience have gained widespread use in recent years. Additionally, many healthcare institutions publish their own patient-education web sites with information regarding common conditions. Little is known about how these resources impact patient health, though, as they have the potential both to inform and to misinform patients regarding their prognosis and possible treatments. In this study we investigated the reliability, readability and quality of information about femoracetabular impingement, a condition which commonly affects young patients.
Methods: The terms “hip impingement” and “femoracetabular impingement” were searched in Google® in November 2013 and the first 30 results were analyzed. The LIDA scale was used to assess website accessibility, usability and reliability. The DISCERN scale was used to assess reliability and quality of information. The FRE score was used to assess readability.
Results: The patient-oriented sites performed significantly worse in LIDA reliability, and DISCERN reliability. However, the FRE score was significantly higher in patient-oriented sites.
Conclusion: According to our results, the websites intended to attract patients searching for information regarding femoroacetabular impingement are providing a highly accessible, readable information source, but do not appear to apply a comparable amount of rigor to scientific literature or healthcare practitioner websites in regard to matters such as citing sources for information, supplying methodology and including a publication date. This indicates that while these resources are easily accessed by patients, there is potential for them to be a source of misinformation.
Mohammad T. Rajabi Mashhadi; Hosein Mashhadinejad; Mohammad H Ebrahimzadeh; Farideh Golhasani-Keshtan; Hanieh Ebrahimi; Zahra Zarei
Volume 3, Issue 1 , January 2015, , Pages 56-63
Abstract
Background: To test the psychometric properties of the Persian version of Zarit Burden Interview (ZBI-12) in the Iranian opulation. Methods: After translating and cultural adaptation of the questionnaire into Persian, 100 caregiver spouses of Iran-Iraq war (1980-88) veterans with chronic ...
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Background: To test the psychometric properties of the Persian version of Zarit Burden Interview (ZBI-12) in the Iranian opulation. Methods: After translating and cultural adaptation of the questionnaire into Persian, 100 caregiver spouses of Iran-Iraq war (1980-88) veterans with chronic spinal cord injury who live in the city of Mashhad, Iran, invited to participate in the study. The Persian version of ZBI-12 accompanied with the Persian SF-36 was completed by the caregivers to test validity of the Persian ZBI-12.A Pearson`s correlation coefficient was calculated for validity testing.In order to assess reliability of the Persian ZBI-12, we administered the ZBI-12 randomly in 48 caregiver spouses again 3 days later. Results: Generally, the internal consistency of the questionnaire was found to be strong (Cronbach’s alpha 0.77). Intercorrelationmatrix between the different domains of ZBI-12 at test-retest was 0.78. The results revealed that majority of questions the Persian ZBI_12 have a significant correlation to each other. In terms of validity, our results showed that there is significant correlations between some domains of the Persian version the Short Form Health Survey -36 with the Persian Zarit Burden Interview such as Q1 with Role Physical (P=0.03),General Health (P=0.034),Social Functional (0.037), Mental Health (0.023) and Q3 with Physical Function (P=0.001),Viltality (0.002), Socil Function (0.001). Conclusions: Our findings suggest that the Zarit Burden Interview Persian version is both a valid and reliable instrument for measuring the burden of caregivers of individuals with chronic spinal cord injury.
Amir Reza Kachooei; Mohammad H. Ebrahimzadeh; Reza Erfani-Sayar; Maryam Salehi; Ehsan Salimi; Shiva Razi
Volume 3, Issue 1 , January 2015, , Pages 45-50
Abstract
Background: We aimed to develop and validate the Persian version of Short Form McGill Pain Questionnaire-2 (SF-MPQ-2) in patients with knee osteoarthritis. Methods: Translation and back translation was performed using Beaton’s guideline. After a consensus has achieved on the Persian version ...
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Background: We aimed to develop and validate the Persian version of Short Form McGill Pain Questionnaire-2 (SF-MPQ-2) in patients with knee osteoarthritis. Methods: Translation and back translation was performed using Beaton’s guideline. After a consensus has achieved on the Persian version of SF-MPQ-2, it was administered to 30 patients with knee osteoarthritis in a pilot study. Then, we enrolled 100 patients with knee osteoarthritis to fill the final SF-MPQ-2 as well as SF-36 and WOMAC questionnaires. Forty-three patients returned 3 days after the initial visit to fill the Persian SF-MPQ-2 for the second time. Construct validity was tested by Pearson’s correlation coefficient between subscales of SF-MPQ-2 and subscales of SF-36 and WOMAC. Internal consistency for total and subscales was calculated by Cronbach’s alpha and reliability between test retest was performed using Intraclass correlation coefficient (ICC). Results: ICC for subscales of SF-MPQ-2 ranged from 0.73 to 0.90. The ICC for total SF-MPQ-2 was 0.90. Cronbach’s alpha for subscales was 0.65-0.74 at the first visit and 0.58-0.81 at the second visit. Cronbach’s alpha for the total questionnaire was 0.88 and 0.91 at the first and second visit, respectively. Pearson’s correlation coefficient was highly significant when comparing subscales specifically with WOMAC (r=-0.47 to -0.61; P<0.001). Interscale correlation between subscales of SF-MPQ-2 was significant as well (r: 0.43-0.88, P<0.001). Conclusions: Persian SF-MPQ-2 showed excellent reliability and good to excellent internal consistency throughout the questionnaire. It is a valid and reliable instrument for measuring the pain intensity and applicable in osteoarthritic pain assessment.
Mohammad H Ebrahimzadeh; Hadi Makhmalbaf; Ali Birjandinejad; Farideh Golhasani keshtan; Hosein Asghar Hoseini; Seyed Mahdi Mazloumi
Volume 2, Issue 1 , March 2014, , Pages 57-62
Abstract
Background: Osteoarthritis of the knee is the most common chronic joint disease that involves middle aged and elderly persons. There are different clinical instruments to quantify the health status of patients with knee osteoarthritis and one example is the WOMAC score that has been translated ...
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Background: Osteoarthritis of the knee is the most common chronic joint disease that involves middle aged and elderly persons. There are different clinical instruments to quantify the health status of patients with knee osteoarthritis and one example is the WOMAC score that has been translated and adapted into different languages. The purpose of this study was cultural adaptation, validation and reliability testing of the Persian version of the WOMAC index in Iranians with knee osteoarthritis. Methods: We translated the original WOMAC questionnaire into Persian by the forward and backward technique, and then its psychometric study was done on 169 native Persian speaking patients with knee degenerative joint disease. Mean age of patients was 53.9 years. The SF-36 and KOOS were used to assess construct validity. Results: Reliability testing resulted in a Cronbach’s alpha of 0.917, showing the internal consistency of the questionnaire to be a reliable tool. Inter-correlation matrix among different scales of the Persian WOMAC index yielded a highly significant correlation between all subscales including stiffness, pain, and physical function. In terms of validity, Pearson`s correlation coefficient was significant between three domains of the WOMAC with PF, RP, BP, GH, VT, and PCS dimensions of the SF-36 health survey (P<0.005) and KOOS (P <0.0001) . Conclusions: The Persian WOMAC index is a valid and reliable patient- reported clinical instrument for knee osteoarthritis.