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Reliability, validity, and responsiveness of the Western Ontario and McMaster Universities osteoarthritis index for elderly patients with a femoral neck fracture

Burgers, Paul T. P. W., Poolman, Rudolf W., Van Bakel, Theodorus M. J., Tuinebreijer, Wim E., Zielinski, Stephanie M., Bhandari, Mohit, Patka, Peter and Van Lieshout, Esther M. M. 2015, Reliability, validity, and responsiveness of the Western Ontario and McMaster Universities osteoarthritis index for elderly patients with a femoral neck fracture, Journal of bone and joint surgery, vol. 97, no. 9, pp. 751-757, doi: 10.2106/JBJS.N.00542.

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Title Reliability, validity, and responsiveness of the Western Ontario and McMaster Universities osteoarthritis index for elderly patients with a femoral neck fracture
Author(s) Burgers, Paul T. P. W.
Poolman, Rudolf W.
Van Bakel, Theodorus M. J.
Tuinebreijer, Wim E.
Zielinski, Stephanie M.
Bhandari, Mohit
Patka, Peter
Van Lieshout, Esther M. M.
Contributor(s) Page, Richard
Journal name Journal of bone and joint surgery
Volume number 97
Issue number 9
Start page 751
End page 757
Total pages 7
Publisher Journal of bone and joint surgery
Place of publication Needham, Mass.
Publication date 2015-05-06
ISSN 0021-9355
1535-1386
Summary Background: The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been extensively evaluated in groups of patients with osteoarthritis, yet not in patients with a femoral neck fracture. This study aimed to determine the reliability, construct validity, and responsiveness of the WOMAC compared with the Short Form-12 (SF-12) and the EuroQol 5D (EQ-5D) questionnaires for the assessment of elderly patients with a femoral neck fracture.

Methods: Reliability was tested by assessing the Cronbach alpha. Construct validity was determined with the Pearson correlation coefficient. Change scores were calculated from ten weeks to twelve months of follow-up. Standardized response means and floor and ceiling effects were determined. Analyses were performed to compare the results for patients less than eighty years old with those for patients eighty years of age or older.

Results: The mean WOMAC total score was 89 points before the fracture in the younger patients and increased from 70 points at ten weeks to 81 points at two years postoperatively. In the older age group, these scores were 86, 75, and 78 points. The mean WOMAC pain scores before the fracture and at ten weeks and two years postoperatively were 92, 76, and 87 points, respectively, in the younger age group and 92, 84, and 93 points in the older age group. Function scores were 89, 68, and 79 points for the younger age group and 84, 71, and 73 points for the older age group. The Cronbach alpha for pain, stiffness, function, and the total scale ranged from 0.83 to 0.98 for the younger age group and from 0.79 to 0.97 for the older age group. Construct validity was good, with 82% and 79% of predefined hypotheses confirmed in the younger and older age groups, respectively. Responsiveness was moderate. No floor effects were found. Moderate to large ceiling effects were found for pain and stiffness scales at ten weeks and twelve months in younger patients (18% to 36%) and in the older age group (38% to 53%).

Conclusions: The WOMAC showed good reliability, construct validity, and responsiveness in both age groups of elderly patients with a femoral neck fracture who had been physically and mentally fit before the fracture. The instrument is suitable for use in future clinical studies in these populations.
Language eng
DOI 10.2106/JBJS.N.00542
Field of Research 110314 Orthopaedics
111799 Public Health and Health Services not elsewhere classified
Socio Economic Objective 920116 Skeletal System and Disorders (incl. Arthritis)
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2015, Journal of bone and joint surgery
Persistent URL http://hdl.handle.net/10536/DRO/DU:30076813

Document type: Journal Article
Collection: School of Medicine
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