Validation of a Nativized Index for Osteoarthritis of the Hip and Knee

Nativization is modification of the components of a system in accordance with the needs of a society without altering its original function. We hypothesized that an index that incorporates Iranian society native specifications would be more sensitive in measurement of hip and knee osteoarthritis severity in comparison to common international indices. Thirty patients with primary osteoarthritis of hip or knee that underwent total joint arthroplasty and fulfilled the criteria were enrolled. Patients were studied using WOMAC, Lequesne, Modified Doyle index, nativized WOMAC index and patient and interviewer global assessment preoperatively and also 6 weeks, 3 months and 6 months post-operatively. "50 feet walking time" and knee range of motion were also studied. The results were analyzed using parametric and nonparametric tests and Pearson coefficient of correlation. The nativized index improved from mean 118 (99-136) pre-operatively to 53.4 (41-68) at 6 weeks post-operatively and 31.5 (23-44) at 6 months. WOMAC and Lequesne improved from mean pre-operative values of 75.6 (55-92) and 18.6 (11-24) to 18.8(17-24) and 6.6 (3-11) at 6 months. Doyle index also improved significantly. Interviewer and patient global assessment improved from mean pre-operative value of 3.4 and 3.9 respectively to 1.5 and 1.9 at 6 weeks and 0.7 and 0.8 at 6 months post-operatively respectively. The most sensitive indices were nativized WOMAC and Lequesne indices. Nativized WOMAC index in knee and hip osteoarthritis demonstrates the severity of symptoms with more sensitivity than other common international indices.