Translation, Adaptation and Validation of the Middle East Lower Limb Score (MELLS) Into Arabic

Abstract

Background: The Middle East Lower Limb Score (MELLS) is an adaptation of the WOMAC questionnaire, specifically adjusted according to the cultural issues of the middle eastern patients with Knee or hip disabilities. The primary objective of this study was to verify if the translation and adaptation of the MELLS into Arabic could be used with ease and consistency by Arab-speaking patients suffering lower limb disabilities.Methods: 110 participants were involved in this study. We performed the internal consistency tests with Cronbach’s alpha. We also calculated floor effects, ceiling effects, as well as test-retest reliability (intra-correlation coefficient). To estimate the validity of MELLS, we used two validated questionnaires – WOMAC and OHS. We confirmed the validity of MELLS questionnaire using Spearman’s correlation.Results: MELLS had a Cronbach’s alpha of 0.88 in the first assessment and 0.92 in the second assessment, which was very high and reliable. Both subscales of MELLS had an internal consistency higher than 0.85. No relevant ceiling and floor effect were observed among the responses. Furthermore, strong significant correlation with WOMAC subscales and OHS was observed, which suggested a good construct validity. Responsiveness of MELLS, however, proved to be lower (but not considerably) than other two questionnaires.Conclusion: The Arabic Middle East Lower Limb Score (MELLS) is a useful and reliable diagnostic tool for Middle eastern patients with knee and hip problems.

Autograft diameter in ACL reconstruction: size does matter

“…The literature has reported that females suffer from ACL ruptures in females 2-4 times more than their male counterparts, however, our sample size only had 6 females in total so they were excluded from this study [4,19]. The authors theorize that this could be due to cultural reasons that generally discourage females from pursuing athletic careers [4][5][6].…”

“…This is why the quadrupled hamstring tendon option has become the mainstay practice in Kuwait for anterior ACLR [ 3 , 4 ]. The reason being for this trend in Kuwaiti orthopedic surgical practice is that the cultural behaviors and daily living practices would be exacerbated by the BPTB related anterior knee pain should it happen [ 5 – 7 ].…”

“…Our null hypothesis was that there would be no correlation between ACLR failure rate and diameter size. The current number of the Kuwaiti population was estimated to be around 5 million people, with the Kuwaitis accounting for 20% of that number [ 5 , 6 , 15 ]. This study was conducted in a tertiary center with the only ACLR facility in the country.…”