Crosscultural adaptation and validation of the simplified Chinese version of the new knee society scoring system.

Authors

Haodong Wu, Dongping Wan, Yishun Guo, Huanli Bao, Zhao Yang, Shuxin Yao, Chao Xu, Jianbing Ma

Published in

Annals of medicine. Volume 57. Issue 1. Pages 2564912. Epub Oct 04, 2025.

Abstract

The 2011 Knee Society Score (new-KSS) describes symptom, satisfaction, expectation, and functional activities in patients undergoing total knee arthroplasty (TKA) and is widely recognized for assessing TKA outcomes. Before using this scale in non-English-speaking populations, it must be translated and culturally adapted to suit the specific demographic.
The new-KSS was translated and culturally adapted into the new-KSS-CV following international guidelines. Item modifications were informed by the Chinese TKA PROM (CTP), a Delphi expert consensus and cognitive interviews with Chinese TKA patients, aiming to reflect local cultural and activity patterns. The adapted scale was applied in a validation study with preoperative and one-year postoperative assessments. Reliability was assessed using intraclass correlation coefficient (ICC) and Cronbach's α. Construct validity was tested by comparing the new-KSS-CV with the Chinese versions of the WOMAC and SF-12. Responsiveness was determined by calculating the standardized response means (SRM).
A total of 226 patients were included, with a mean age of 64.7 ± 5.7 years; 142 (62.8%) were female. All patients completed both preoperative and one-year postoperative assessments. Ceiling effects were observed preoperatively in the expectation dimension (40.7% of patients) and postoperatively in symptom (54.4%), functional (72.1%), and standard activities (19.0%) domains. The new-KSS-CV showed good to excellent test-retest reliability (ICC: 0.88-0.97) and internal consistency (Cronbach's α: 0.74-0.85). The total score correlated significantly and moderately negatively with WOMAC (r = -0.68, p < 0.001), while the symptom (r = -0.41), satisfaction (r = -0.42), and functional activities (r = -0.66) domains also showed significant weak to moderate negative correlations (all p < 0.001). The expectation domain showed a very weak but significant positive correlation (r = 0.19, p = 0.005). The functional activities domain and total score of the new-KSS-CV correlated significantly and positively with the SF-12 physical component (r = 0.57 and 0.50, respectively; p < 0.001). The new-KSS-CV demonstrated a higher SRM (3.89) than WOMAC (-2.41) and SF-12 (1.69 and 0.33).
The new-KSS-CV is a reliable, valid, responsive, and consistent outcome measurement tool that can be used to evaluate the outcome of TKA in Chinese patients.

PMID:
41045295
Bibliographic data and abstract were imported from PubMed on 04 Oct 2025.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.