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. 2025 Jun 5;13(6):23259671251340989.
doi: 10.1177/23259671251340989. eCollection 2025 Jun.

Reliability and Validity of the Arabic Translated Version of the Norwich Patellar Instability Score and the Banff Patellar Instability Instrument 2.0

Abdulaziz Z Alomar  1 , Faisal A Alghamdi  2 , Ahmed S Alhowimel  3 , Faris Alodaibi  4 , Dalia Alimam  4
Affiliations

Reliability and Validity of the Arabic Translated Version of the Norwich Patellar Instability Score and the Banff Patellar Instability Instrument 2.0

Abdulaziz Z Alomar et al. Orthop J Sports Med. .

Abstract

Background: The Banff Patellar Instability Instrument 2.0 (BPII 2.0) and Norwich Patellar Instability (NPI) score are reliable, valid patient-reported outcome (PRO) measures for evaluating patellofemoral instability. Both have been translated and culturally adapted to various languages to document PROs accurately. However, no validated Arabic versions of these PRO measures exist.

Purpose: To translate the BPII 2.0 and NPI score into Arabic and assess the reliability and validity of the translated questionnaires.

Study design: Cohort study (diagnosis); Level of evidence, 3.

Methods: The NPI score and BPII 2.0 were translated into Arabic based on standard guidelines recommended by the Consensus-based Standards for the selection of health Measurement Instruments. Patients who underwent patellofemoral stabilization surgery were included in this study. Respondents completed the translated versions of the questionnaires 1 week apart. The validity of the translation was assessed using Cronbach alpha, and Pearson correlation coefficient (r) was used to determine the relationship between the Arabic versions of the NPI score, BPII 2.0, and Kujala Score (KS). Test-retest reliability was assessed using the intraclass correlation coefficient.

Results: The translated versions were assessed in 83 patients and found reliable. The response rate was 94.3%. A negative correlation was found between the KS and NPI score (r = -0.80; P < .05) and a positive correlation with BPII (r = 0.84; P < .05). A significant negative correlation was noted between the NPI and the BPII (r = -0.71). For first-time responses, Cronbach alpha for the NPI score was 0.80, with an intraclass correlation coefficient of 0.80 (0.68-0.83), while the BPII was 0.91 (0.87-0.93) and the KS was 0.80 (0.73-0.86). No floor or ceiling effects were observed.

Conclusion: The study demonstrated that the translated Arabic versions of the BPII and NPI score are valid and reliable for measuring PROs in Arabic-speaking patients with patellofemoral instability.

Keywords: Arabic translation; Banff Patellar Instability Instrument; Norwich Patellar Instability score; patellar instability; patellofemoral instability; patellofemoral pain syndrome; patient-reported outcome.

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Conflict of interest statement

The authors declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Flowchart of the questionnaire translations from English to Arabic. ATBPII, Arabic translation of Banff Patellar Instability Instrument; ATNPI, Arabic translation of Norwich Patellar Instability score; BPII, Banff Patellar Instability Instrument; E, English; NPI, Norwich Patellar Instability score.
See this image and copyright information in PMC

References

    1. Acquadro C, Conway K, Giroudet C, Mear I. Linguistic Validation Manual for Patient-Reported Outcomes (PRO) Instruments. Mapi Research Institute; 2004;184.
    1. Acquadro C, Jambon B, Ellis D, Marquis P. Language and translation issues. In: Spilker B, ed. Quality of Life and Pharmaco Economics in Clinical Trials. Lippincott-Raven Publishers; 1996:575-585.
    1. Aldharman SS, Almuhammadi HH, Madkhali AY, et al.. Prevalence of patellofemoral pain and knee pain in the general population of Saudi Arabia. Cureus. 2022;14(10):e30355. - PMC - PubMed
    1. Aljuhani W, Aloufi L, Alhafi ME, et al.. Prevalence of patellofemoral pain among adults in Saudi Arabia. Cureus. 2024;16(11):e74818. - PMC - PubMed
    1. Arrebola LS, Campos TVO, Smith T, Pereira AL, Pinfildi CE. Translation, cross-cultural adaptation and validation of the Norwich Patellar Instability score for use in Brazilian Portuguese. Sao Paulo Med J. 2019;137:148-154. - PMC - PubMed

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