Anatomic anterior cruciate ligament reconstruction scoring checklist: Spanish language validation

Abstract

Introduction: An ideal arthroscopic anterior cruciate ligament (ACL) reconstruction aims to restore the anatomy and function of the knee to its original state. The Anatomic ACL Reconstruction Score Checklist (AARSC) has been validated and used to assess reconstruction techniques described in the literature.

Objectives: To validate the Colombian Spanish version of the AARSC in terms of inter-rater reliability, construct validity, and internal consistency as a tool for assessing ACL reconstruction surgical techniques described in the literature.

Methodology: Study to validate the AARSC in Colombian Spanish developed in two phases: 1) translation and adaptation to Colombian Spanish, and 2) validation. The validation process followed the methodology used by the creators of the checklist. Eighteen articles describing ACL reconstruction (ACRL) techniques were selected and reviewed by 4 senior knee surgeons without any pre-established criteria and by 6 orthopedists using the AARSC (54 evaluations; 3 per article; all with experience in ACRL). Internal consistency, inter-rater reliability, and construct validity were determined by calculating Cronbach's alpha, intraclass correlation coefficient (ICC), and Spearman's correlation coefficient (rho), respectively. Cohen's Kappa coefficient was also calculated to assess agreement between senior orthopedists’ assessments.

Results: The internal consistency of the list was poor (Cronbach’s alpha= 0.591). The agreement between the evaluations made by experts based on their own opinion was moderate or poor (Cohen’s Kappa: 0.48, 0.31, and 0.36). The ICC was 0.613 for consistency and 0.610 for absolute agreement, which shows a substantial correlation between the evaluations made using the AARSC. However, there was no correlation between assessments performed by senior orthopedists and those performed using the checklist in most cases (rho= 0.014 -0.433).

Conclusions: Although it was not possible to establish the validity of the Colombian Spanish version in our study, some elements of the AARSC might be useful to evaluate the anatomic nature of a reconstruction in the ACRL techniques described in the literature.