Cross-Cultural Adaptation and Validation of the Hong Kong Version of the Knee Injury and Osteoarthritis Outcome Score (HK-KOOS) for Patients with Knee Osteoarthritis

ThisstudyaimedtovalidatetheHongKongversionoftheKneeInjuryandOsteoarthritisOutcomeScore(HK- KOOS)forpatientswithkneeosteoarthritis.Methods.ContentvaliditywasassessedusingtheItemandScaleContentValidity Index(I-CVIandS-CVI).Test-retestreliabilityandinternalconsistencywereassessedbytheIntraclassCorrelationCoefficient (ICC)andCronbach’salpha.Dimensionalitywasassessedbyperformingexploratoryfactoranalysis(EFA).Convergentand DivergentValiditywasperformedbyexaminingthecorrelationbetweentheHK-KOOSandtheChineseversionofthe ShortForm12(SF-12)HealthSurvey,theChineseModifiedBarthelIndex(C-MBI),andtheVisualAnalogueScalefor Pain(VAS-Pain).Ceilingandflooreffectswerealsoexamined.Results.Atotalof125participantswererecruitedinthis study.Ingeneral,allinstructions,items,andresponseoptionswereconsideredasunderstandable,indicatingasatisfactory cross-culturaladaptation.TheI-CVIandS-CVIscoreswere0.80-1and0.90-1,respectively,indicatingexcellentcontent validityintermsofrelevance,representativeness,andunderstandability.Thetest-retestreliabilityofallHK-KOOSsubscales wassatisfactorywithICCexceeding0.70foralldomains.Cronbach’salphaexceeded0.80forallsubscales,indicating satisfactoryinternalconsistency.MediumtostrongcorrelationswerefoundbetweentheHK-KOOSandtheVAS-Pain,SF-12, andC-MBI.However,factoranalysisindicatedaseven-factorstructure,ratherthantheoriginalfive-factorstructure.Itemson painandactivitiesofdailylivingwereloadedinthesamefactors.Aflooreffectwaspresentinthesportsandrecreation subscale.DiscussionandConclusions.FuturestudiesshouldfurtherexaminethedimensionalityoftheKOOS.TheHK-KOOSis aculturallyadapted,reliable,andvalidoutcomemeasureinstrumenttobeusedinHongKongpatientswithprimaryknee osteoarthritis