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

Abstract

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.

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.

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.

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

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

A written informed consent was obtained from each patient.

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