Translation, Cross-Cultural Adaptation and Psychometric Properties of the Urdu Version of Lysholm Knee Score for Pakistani Population

SUMMARY
Background. The Lysholm knee score, initially introduced in 1982 and modified in 1985, consists of eight items developed to assess knee function after ligamentous injury. It is widely used tool for measuring patient reported outcomes. However, as the tool evolved in English, makes its use restricted to only English-language populations. The purpose of this study is to translate, culturally adapt and measure the psychometric properties of the Urdu version of Lysholm knee score for Pakistan.
Methods. The Lysholm knee score was translated and culturally adapted into Urdu in accordance with Guillemin’s recommendations. A total of 100 participants with patellar tendinopathy were recruited at our hospital. The translation and cross culture adaptation procedure for U-LKS was developed in five steps procedure. Next, Cronbach’s alpha, intraclass correlation coefficient (ICC), Pearson’s correlation coefficient (r) was calculated to evaluate reliability and validity of U-LKS respectively. The correlations between the Lysholm knee score, Kujala Anterior Knee Pain Scale, and SF-36 was used
to evaluate external validity. Floor and ceiling effects were also assessed.
Results. Overall, 100 Patients with patellar tendinopathy successfully completed the Urdu-language Lysholm knee score. Acceptable internal consistency (Cronbach’s alpha = 0.769) and excellent test-retest reliability (ICC = 0.823) were calculated for U-LKS. There was strong correlation between Lysholm knee score and Kujala Anterior Knee Pain Scale (r = 0.837), high correlations between Lysholm Urdu version with the physical component domain of SF-36 score (r = 0.523-0.622) and a low association with the SF-36 mental component domain (0.163-0.303).
Conclusions. The Urdu version of the Lysholm knee score is valid and reliable measuring tool and can be used in clinical and research settings for patients with patellar tendinopathy. It is quickly administered and has good psychometric properties.