Oya Kalaycıoğlu1, Tacettin Ayanoğlu2, Ömer Faruk Yılmaz2, Mahmut Timur Turhan2

1Department of Biostatistics and Medical Informatics, Bolu Abant İzzet Baysal University, Bolu, Türkiye
2Department of Orthopedics and Traumatology, Bolu Abant İzzet Baysal University, Bolu, Türkiye

Keywords: American Orthopaedic Foot and Ankle Society, hallux, metatarsophalangeal joint.reliability, Turkish, validity.


Objectives: In this study, we aimed to translate and culturally adapt the American Orthopaedic Foot and Ankle Society (AOFAS) Hallux Metatarsophalangeal (MTP)-Interphalangeal (IP) scale, which is used for the clinical assessment of patients with hallux valgus (HV), into Turkish and to evaluate its validity and reliability.

Patients and methods: Between February 2022 and October 2022, a total of 67 patients (18 males, 49 females; mean age: 51.5±15.9 years; range, 18 to 68 years) with HV deformity and able to communicate in Turkish were included. Following the translation of the AOFAS hallux MTP-IP scale into Turkish, its cultural appropriateness was confirmed. Intra-rater and inter-rater reliabilities were assessed by intraclass correlation coefficients (ICCs), using data collected by two orthopedists. Agreement among test-retest evaluations was conducted using the Bland-Altman analysis. The construct validity of the scale was determined by the Manchester-Oxford Foot Questionnaire (MOXFQ) and Short Form Health Survey (SF-36). Content validity was confirmed by the floor/ceiling effects.

Results: The Turkish AOFAS hallux MTP-IP had an excellent intra-rater reliability of 0.971. The intra-rater reliability of the pain, function, and alignment subscales ranged from 0.904 to 0.978. The inter-rater reliability was 0.913 for the total score, while ranging from 0.838 to 0.918 for the subscales. The total score of the AOFAS hallux MTP-IP had a high correlation with the physical domains of the MOXFQ and SF-36, while weaker correlations with mental domains were observed. No floor/ceiling effect was observed for the overall Turkish AOFAS hallux MTP-IP.

Conclusion: The Turkish translated and culturally adapted AOFAS hallux MTP-IP scale is a valid and reliable measure, ensuring its use in assessing the clinical status of Turkish patients with HV deformity.

Citation: Kalaycıoğlu O, Ayanoğlu T, Yılmaz ÖF, Turhan MT. A cross-cultural adaptation and validation of the Turkish version of American Orthopaedic Foot and Ankle Society Metatarsophalangeal-Interphalangeal Scale (AOFAS-MTP-IP) for the hallux. Jt Dis Relat Surg 2023;34(2):305-314. doi: 10.52312/ jdrs.2023.1141.

Ethics Committee Approval

The study protocol was approved by the Bolu Abant Izzet Baysal University Clinical Research Ethics Committee (date: 08.02.2022, no: 2022/14). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Idea/concept, design, interpretation, writing the article: O.K., T.A.; Data collection: T.A., O.F.Y., M.T.T.; Analysis: O.K.; Literature review, final approval: O.K., T.A., O.F.Y., M.T.T.; Critical review, materials: O.K., T.A., O.F.Y., M.T.T.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.