COSMIN database

Do patient-reported outcome measures in hip and knee arthroplasty rehabilitation have robust measurement attributes? A systematic review

Alviar, M. J., Olver, J., Brand, C., Tropea, J., Hale, T., Pirpiris, M., and Khan, F.
OBJECTIVE: The aim of this study was to systematically review and compare the measurement attributes of multidimensional, patient-reported outcome measures used in hip and knee arthroplasty rehabilitation.

METHODS: A search of PubMed, CINAHL, Cochrane Central Registry, SCOPUS and PEDro databases up to December 2009 identified the validation studies. The quality of the measurement properties were assessed based on the Terwee and Bot criteria, and Scientific Advisory Committee of the Medical Outcomes Trust guidelines.

RESULTS: A total of 68 studies examining 28 instruments were identified. Three instruments had positive ratings for content validity. None of the instruments satisfied both factor analysis and Cronbach's alpha criteria for internal consistency. Four measures were positively-rated for agreement. Nine tools had positive ratings for construct validity. Twenty-four of the instruments had indeterminate ratings for responsiveness to clinical change. Only certain subscales of 2 instruments were positively-rated for responsiveness to clinical change.

CONCLUSION: A wide variety of multidimensional patient-reported instruments has been used to assess rehabilitation outcomes after hip and knee arthroplasty, but information about their measurement attributes in these populations is inadequate. More data are needed to clarify their reproducibility and responsiveness to clinical change.

J Rehabil Med
Publication year:
Functional status:
Physical functioning
Adults (18-65)
Seniors (65+)
Diseases of and symptoms related to the musculoskeletal system and connective tissue
PRO / non-PRO:
Non-patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
6 - Clinical rating scales
AIMS - Arthritis Impact Measurement Scales (Also short AIMS and shortened AIMS)
EQ-5D - EuroQoL-5 Dimensions   
FSI - Fatigue Symptom Inventory
FSQ - Functional Status Questionnaire
HAQ - Health Assessment Questionnaire (versions:MHAQ - Modified HAQ; HAQ-II)   
HOOS - Hip disability and Osteoarthritis Outcome Score   
HRQ - Hip Rating Questionnaire
HUI - Health Utilities Index
LAI-hip - Lequesne Algofunctional Index for the severity of osteoarthritis of the hip [alias: LISH][alias: LISOH]   
LAI-knee - Lequesne Algofunctional Index for the severity of osteoarthritis of the knee [alias: LISK][alias: LISOK]   
LEAP - Lower Extremity Activity Profile
LHS - London Handicap Scale   
MHAQ - Modified Health Assessment Questionnaire
MODEMS Hip/Knee Core Scale - Musculoskeletal Outcomes Data Evaluation and Management Systems Hip/Knee Core Scale
NHP - Nottingham Health Profile   
OHS - Oxford Hip Score   
OKS - Oxford Knee Score   
PFH - Pain and Function of the Hip
QWB - Quality of Well-Being Scale
sAIMS - Shortened Arthritis Impact Measurement Scales
SF-12 - 12-item Short Form Health Survey [alias: RAND-12]
SF-6D - Short-Form 6D (derived from SF-36 or F-12)
SFMA-D - Short Musculoskeletal Function Assessment Questionnaire
SIP - Sickness Impact Profile   
WHOQOL-BREF - World Health Organization Quality of Life questionnaire–Abbreviated Questionnaire [alias: WHO-QOL BREF]   
WOMAC - Western Ontario and McMaster Universities Osteoarthritis Index (Also I-WOMAC - Individualized WOMAC)