International Knee Documentation Committee (IKDC) score calculator . of the pediatric versus adult IKDC Subjective Knee Evaluation Form in adolescents. IKDC SUBJECTIVE KNEE EVALUATION FORM. Your Full Name______________________________________________________. Today’s Date. Date of completion. IKDC SUBJECTIVE KNEE EVALUATION FORM . Thank you very much for completing all the questions in this questionnaire.
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Patient-reported measures of knee function are important for the comprehensive assessment of rheumatology conditions in both clinical and research contexts. To merit inclusion in this review, measures of knee function were required to be patient reported and assess aspects considered important by adult patients with knee problems such as injury or osteoarthritis OA.
Therefore, measures used in rheumatology, orthopedics, ikdd sports medicine were considered. Dimensions deemed to be important to patients included pain, function, quality of life, and activity level.
To identify instruments fulfilling these criteria, we utilized published reviews of knee instruments 1knee OA instruments 2and measures for use in patellofemoral arthroplasty 3.
Based on these reviews, as well as extensive searches of more recent literature, we included the following 9 patient-reported outcomes: Although the WOMAC can be applied to the hip and knee, this study contains data only applicable to the knee.
Measures assessing activity level are listed separately. The number of psychometric reports concerning each instrument ranges from 2— A higher number of reports indicates a higher degree of certainty in interpretation of the psychometric properties. Psychometric properties were based on data provided in Tables 1 and 2, and interpreted using standardized guidelines.
Measures were deemed to have face validity if the reviewers considered that the items adequately reflected the measured construct, or if studies reported that expert panels had made a similar assessment 8.
Construct validity was considered adequate if expected correlations were found with existing measures that assess similar convergent construct validity and dissimilar divergent construct validity constructs 7. As there is no gold standard measure of patient-reported outcome, criterion validity is not applicable to this review. In this context, the minimum clinically important difference is the amount of change of a patient-reported outcome that represents a meaningful change to the patient, while the patient-acceptable symptom state is the least abnormal function score at which patients would consider themselves having acceptable function To detect improvement or deterioration in symptoms, function, and sports activities due to knee impairment Patients with a variety of knee conditions, including ligament injuries, meniscal injuries, articular cartilage lesions, and patellofemoral pain The IKDC was formed in to develop a standardized international documentation system for knee conditions.
It has undergone subsequent minor revisions since its publication in The items now have the allocated scores next to each possible response. The minimum score for each item has also been changed so that it is now 0, not 1. The scoring of the numerical rating scales for items 2 and 3 has been reversed so that 0 represents the highest level of symptoms and 10 represents the lowest level of symptoms, which is in line with the scoring of the rest of the items.
Response options vary for each item. Not specified for items 1, 3, 5, 7, 8, and 9; 4 weeks for items 2, 4, and 6.
Function prior to knee injury for item 10a and current function for 10b. Multiple web sites have published versions of the form. The form has not been validated for administration by interview, either in person or via telephone. The response to each item is scored using an ordinal method i. The most recent version has assigned scores for each possible response printed on the questionnajre.
Scores for each item are summed to give a total score excluding item 10a. An online scoring sheet is available www. The item regarding knee function prior to knee injury is not included in the total score. The revised scoring method states that, in cases where patients have up to 2 missing values i.
It uses simple language that is suitable for patients. Approximately 5 minutes to score. Training is not necessary. Manual scoring can be performed easily using the scoring instructions supplied with the questionnaire. Cross-cultural adaptations have been conducted for the Brazilian 16Chinese 17Dutch 18Italian 15dorm Thai 19 translations. Item-response theory was used to create the scoring system.
Measures of Knee Function
Patients were not involved in development; rather, items were selected by the IKDC, a committee of international orthopedic surgeons Studies consistently report no floor or ceiling effects i. Internal consistency is adequate for patients with ikdx injuries and mixed knee pathologies Table 1. Test—retest reliability is adequate for groups of patients with knee injuries and mixed pathologies and individuals with knee injuries.
However, test—retest reliability is slightly below adequate for individuals who fall into a broader category of knee pathologies. The minimal detectable change has been reported to be between 8. The domains covered by the IKDC appear to represent elements that are likely to be important to patients.
However, the lack of patient contribution to the selection and revision of items in the IKDC means that content validity cannot necessarily be assumed. There are consistent reports of high convergent and divergent construct validity, with the IKDC more strongly correlated with the Short Form 36 SF physical subscales and component summary than with the mental subscales and component summary 1116 — 1820 In patients undergoing surgical treatment of meniscal injury, the IKDC shows large effect sizes at 1 year Table 2.
For patients who have had surgical intervention for cartilage injury, the IKDC shows moderate effect sizes at 6 months and large effect sizes at 1 year.
Large effect sizes have been reported from 6—28 months following various surgical procedures conducted in a mixed cohort of knee pathologies. The minimum clinically important difference has been reported to questionnair 6. The patient-acceptable symptom state has not forj determined. At face value, the domains covered by the IKDC appear to represent elements that are likely to be important to patients.
It shows adequate internal consistency and has no floor or ceiling effects across mixed groups of patients with knee conditions. The IKDC has been shown to be responsive to change following surgical interventions, highlighting its usefulness in this patient population.
Despite demonstrating face validity, the lack of patient contribution to item selection indicates that content validity cannot necessarily be assumed.
The relatively long recall period associated with 3 of the items may be a problem for some patients. The use of 1 aggregate score to represent symptoms, activities, and function may mask deficits in 1 domain. Psychometric testing is lacking for patients with knee osteoarthritis as an isolated group, as well as responsiveness following non-surgical management, highlighting areas for quesstionnaire studies.
Measures of Knee Function
The IKDC involves minimal administrative and respondent burden, and can be easily scored in the clinic using the online scoring sheet. Test—retest reliability for idc with various knee pathologies suggests that the IKDC may demonstrate inadequate reliability for the evaluation of individual patients. Psychometric evaluation supports the use of the IKDC in research for a variety of knee conditions.
As some versions of the IKDC published online contain subtle differences in the wording of instructions and items, researchers should ensure that they utilize the version published as a component of the IKDC Knee Forms to ensure that findings of psychometric properties still apply, and that comparisons can be made with previous studies. Administrative and respondent burden would not limit research use, although researchers should be diligent in checking for missing data.
Young and middle-aged people with posttraumatic osteoarthritis OAas well as those with injuries that may lead to posttraumatic OA e. Questionnire original KOOS remains unchanged, although a short form for function has been developed.
All items are rated on a 5-point Likert scale 0—4specific to each item. Not defined for QOL subscale. The KOOS and associated documentation are freely available at www. The KOOS has not been validated for use during an in-person or telephone interview. Scoring sheets manual and computer spreadsheets are provided on the web site.
Each item is scored from 0—4. The 5 dimensions are scored separately as the sum of all qjestionnaire items. A total score has not been validated and is not recommended. If a mark is placed outside a box, the closest box ofrm chosen. If 2 boxes i,dc marked, that which indicates more severe problems is chosen. One or 2 missing values within a questionnaier are substituted with the average value for that subscale.
Population-based normative data are available, stratified by age and sex The KOOS takes 10 minutes to complete It uses simple language questoonnaire similar 1-word responses for each item. The items largely reflect signs and symptoms of their knee condition and how this affects everyday tasks, so it is not considered that they would have an emotional impact on the individual.
The knee-related QOL subscale could be considered the most forn sensitive component, as it requires the individual to reflect on how their knee affects their QOL.
Approximately 5 minutes to score, using the scoring spreadsheet.
International Knee Documentation Comitee – Orthopaedic Scores
Training is not necessary, as the components of the KOOS and the scoring instructions are self-explanatory. Cross-cultural adaptations have been conducted for the Swedish 2728Chinese 29Dutch 30French 31Persian 32Portuguese 33Russian Golubev; www.
Items were selected based on: Item-response theory was not used in the development of KOOS or for item selection Reported rates of missing data are low: Studies consistently report no or acceptable floor or ceiling effects in knee injury cohorts 273236 and in patients with mild or moderate knee Quesionnaire 282931 In knee OA, pain and ADL subscales have adequate test—retest data, while for the other subscales, reports indicate both lower and adequate test—retest reliability.
Across the 5 subscales, the minimal detectable change ranges from 6—12 for knee injuries and from The standard error of the measure is qustionnaire to be lower for knee injuries than for OA. As well as exhibiting face validity, the iikdc involvement of patients with knee conditions in the development of the KOOS facilitates content validity 25 A more recent study reported that quetionnaire KOOS subscales had questioonnaire dimensionality The KOOS appears to be responsive to change in patients with a variety of conditions that have been treated with nonsurgical and surgical interventions Table 2.
In patients who have undergone partial meniscectomy 3 months previously, large effect sizes are seen on all but the ADL subscale. Large effect sizes are seen in all subscales 6 months after ACL reconstruction. Large effect sizes are consistently reported on all subscales 3—12 months after TKR.