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Introduction. The Oxford Knee Score (OKS) is a reliable, valid and sensitive assessment tool for individuals having a total knee arthroplasty (TKA). The published psychometric assessment of the Arabic version of OKS (OKS-Ar) is limited to male patients and has no assessment of responsiveness following TKA.Aim. To assess the reliability, validity and responsiveness of the OKS-Ar in inclusive patients undergoing TKA.Methods. One hundred Arabic-speaking patients awaiting TKA were assessed with OKS-Ar, the Arabic version of the Knee Injury and Osteoarthritis Outcome Score (KOOS-Ar), and a visual analogue scale for pain (VAS-P), in order to assess the correlation between OKS-Ar and KOOS-Ar and VAS-P and determine the construct validity. Repeat assessments were completed 7-10 days later and six months post-TKA.Results. Questionnaires were completed by 80 female and 20 male participants with a mean age of 60 years and 69 years respectively. The test and re-test median scores showed no significant difference, with a strong Spearman's correlation between the two measurements (rs=.94). Bland-Altman's limits of agreement showed no significant bias. Cronbach's α was 0.98, indicating high internal consistency. There was no floor or ceiling effect pre-TKA, and the post-TKA ceiling effect was only 2%. The OKS-Ar pain component correlated strongly with the KOOS-Ar pain subscale (rs=.73). The OKS-Ar effect size was 3.09, which is larger than all KOOS subscales at six months post -TKA. Conclusion. This is the first study to assess OKS-Ar's reliability, validity and responsiveness post-TKA. The validity and reliability results are like those found for both the original English

Objective: To date, no study has explored patients' experiences, outcome expectations and satisfaction 1-year post-total knee arthroplasty (TKA) using focus-group discussion (FGD). The exploration of patients' expectations, functional recovery and limitations may support future modifications and thus improve outcomes post-TKA. Methods: An FGD was conducted with patients at 1-year post-TKA. Moderators led the discussion using a semistructured discussion guide. The discussion was digitally recorded, transcribed verbatim and analysed to formulate themes. Results: The study identified four main themes: recovery experience post-TKA, experience before TKA, activity of daily living (ADL) changes post-TKA and post-TKA outcome expectations. The recovery experience theme explores the overall experience post-TKA in terms of symptoms and progression issues; their experience with the orthopaedic surgeon and physiotherapy; and the differences between first and second knee replacements. The experience before TKA theme discusses many issues raised by patients that they believed strongly affected TKA outcomes and their satisfaction, such as the referral process, ADL limitations before TKA and their beliefs about post-TKA outcomes. The ADL changes post-TKA theme discusses the diversity of functional improvements, limitations and new functional ability. The outcome expectation theme explores what the patients expected to gain from surgery and the factors that modified those expectations, and whether their expectations were met. Conclusions: Patient attitude, sufficient preoperative education, outcome expectation modification, communication with the surgeon and patients taking an active role in rehabilitation can all affect post-TKA outcomes and satisfaction. Hence, the recommendation is to address all of these issues before TKA to enhance outcomes and patient satisfaction.