Validation of the French version of two on high-activity knee questionnaires

Self-administered quality-of-life questionnaires are valuable evaluation tools in orthopedic surgery. The conventional questionnaires are limited by a substantial ceiling effect. We wished to validate a French translation of two English questionnaires for high-activity patients: the High-Activity Arthroplasty Score (HAAS) and the Activity Scale for Arthroplasty Patients (ASAP). One hundred patients operated on for knee replacement were selected. The answers to both questionnaires were analyzed and compared to the Oxford Knee Score (OKS) and to the scoring system of the American Knee Society (AKS).

There is no correlation between the results of both high-activity questionnaires and of the two conventional scoring systems.

All questions were easily understood. The mean scores of the HAAS and ASAP questionnaires were 8.2±3.0 and 30.7±9.6, respectively. The distributions were not considered normal. There was no floor effect, but there was a limited ceiling effect (0% and 14%, respectively). The internal coherence of both questionnaires was satisfactory. There was a significant correlation between the high-activity scores and the conventional scores.

Both high-activity questionnaires in our French translation can potentially measure the overall function of a patient after knee replacement as accurately as the index English version. It is self-administered, easy to use, can collect patients' answers by postage mailing, and involves no ceiling effect. All these points should allow its routine use for evaluation after knee replacement. The HAAS evaluation seems to be superior to the ASAP evaluation.

Case-control study, level III.