{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:22:28Z","timestamp":1788434548736,"version":"build-2803163510"},"reference-count":25,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ActaO"],"abstract":"<jats:p>Background and purpose:\u00a0Patient-reported outcome measures need to reflect true differences rather than measurement artifacts resulting from translations when scores are compared across countries. We evaluated the measurement invariance of the English, Dutch, Danish, and French Oxford Hip Score (OHS) and Oxford Knee Score (OKS) in patients undergoing hip and knee arthroplasty.Methods:\u00a0OHS and OKS responses from patients undergoing primary hip or knee arthroplasty for osteoarthritis between 2019 and 2022 were included from national and single-center registries in the United Kingdom, the Netherlands, Denmark, and Switzerland. We evaluated unidimensionality, monotonicity (Hi &gt; 0.3) and local independence (Yen Q3 &gt; 0.20 above the average indicating independence) in each language version separately. Model fit was considered satisfactory when Comparative Fit Index (CFI) and Tucker\u2013Lewis Index (TLI) were \u2265 0.95, root mean square error of approximation (RMSEA) \u2264 0.06, and standardized root mean square residual (SRMR) \u2264 0.08. Measurement invariance across languages was analyzed with multiple group\u2014confirmatory factor analysis on full, random, and matched sample datasets.Results:\u00a0Across the hip and knee cohorts, unidimensionality was acceptable in the English (n = 21,108 and 28,230), Dutch (n = 36,792 and 29,651), Danish (n = 815 and 1,015), and French (n = 590 and 459) versions. RMSEA ranged from 0.072 to 0.092 for OHS, and from 0.057 to 0.061 for OKS and other fit indices were acceptable. The multiple group-confirmatory factor analysis showed acceptable measurement invariance across languages for both scores, with changes in RMSEA &lt; 0.15 and CFI &lt; 0.1 across gradually more constrained models.Conclusion:\u00a0Measurement invariance of the OHS and OKS was supported across the English, Dutch, Danish, and French versions, with multiple group-confirmatory factor analyses model fit within predefined acceptable limits, supporting cross-comparison of the different language versions of these instruments.<\/jats:p>","DOI":"10.2340\/17453674.2026.46545","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:09:25Z","timestamp":1788433765000},"source":"Crossref","is-referenced-by-count":0,"title":["The Oxford Hip and Knee Scores in patients undergoing hip and knee arthroplasty: cross-cultural validation study based on 110,000 patients"],"prefix":"10.2340","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2261-7709","authenticated-orcid":false,"given":"Lina H","family":"Ingelsrud","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiraz A","family":"Sabah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Bohm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl B","family":"Christensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0132-8182","authenticated-orcid":false,"given":"Anders","family":"Troelsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J","family":"Price","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anneke","family":"Spekenbrink-Spooren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6905-6120","authenticated-orcid":false,"given":"Anne","family":"L\u00fcbbeke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Barea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8591-5629","authenticated-orcid":false,"given":"Jasper","family":"Most","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conrad","family":"Harrison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Mark","family":"Wilkinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"167242","doi-asserted-by":"crossref","unstructured":"Dawson J, Fitzpatrick R, Carr A, Murray D. Questionnaire on the perceptions of patients about total hip replacement. J Bone Joint Surg Br 1996; 78-B(2): 185-90. doi: 10.1302\/0301-620X.78B2.0780185.","DOI":"10.1302\/0301-620X.78B2.0780185"},{"key":"167243","doi-asserted-by":"crossref","unstructured":"Dawson J, Fitzpatrick R, Murray D, Carr A. Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg 1998; 80(1): 63-9. doi: 10.1302\/0301-620X.80B1.7859.","DOI":"10.1302\/0301-620X.80B1.0800063"},{"key":"167244","doi-asserted-by":"crossref","unstructured":"Lingard M C H, Frampton C M A, Hooper G J. Do patient-reported outcome scores better identify outlier surgical practice compared with revision rates for total knee arthroplasty? Acta Orthop 2025; 96: 467-76. doi: 10.2340\/17453674.2025.44037.","DOI":"10.2340\/17453674.2025.44037"},{"key":"167245","doi-asserted-by":"crossref","unstructured":"Harris K, Dawson J, Gibbons E, Lim C, Beard D, Fitzpatrick R, et al. Systematic review of measurement properties of patient-reported outcome measures used in patients undergoing hip and knee arthroplasty. Patient Relat Outcome Meas 2016; 7: 101-8. doi: 10.2147\/PROM.S97774.","DOI":"10.2147\/PROM.S97774"},{"key":"167246","doi-asserted-by":"crossref","unstructured":"Collins N J, Roos E M. Patient-reported outcomes for total hip and knee arthroplasty: commonly used instruments and attributes of a \u201cgood\u201d measure. Clin Geriatr Med 2012; 28(3): 367-94. doi: 10.1016\/j.cger.2012.05.007.","DOI":"10.1016\/j.cger.2012.05.007"},{"key":"167247","doi-asserted-by":"crossref","unstructured":"Haverkamp D, Breugem S J M, Sierevelt I N, Blankevoort L, Van Dijk C N. Translation and validation of the Dutch version of the Oxford 12-item knee questionnaire for knee arthroplasty. Acta Orthop 2005; 76(3): 347-52. doi: 10.1080\/00016470510030814.","DOI":"10.1080\/00016470510030814"},{"key":"167248","doi-asserted-by":"crossref","unstructured":"Jenny J Y, Diesinger Y. Validation of a French version of the Oxford knee questionnaire. Orthop Traumatol Surg Res 2011; 97(3): 267-71. doi: 10.1016\/j.otsr.2010.07.009.","DOI":"10.1016\/j.otsr.2010.07.009"},{"key":"167249","doi-asserted-by":"crossref","unstructured":"Delaunay C, Epinette J A, Dawson J, Murray D, Jolles B M. Cross-cultural adaptations of the Oxford-12 HIP score to the French speaking population. Orthop Traumatol Surg Res 2009; 95(2): 89-99. doi: 10.1016\/j.otsr.2009.01.003.","DOI":"10.1016\/j.otsr.2009.01.003"},{"key":"167250","doi-asserted-by":"crossref","unstructured":"Paulsen A, Odgaard A, Overgaard S. Translation, cross-cultural adaptation and validation of the Danish version of the Oxford hip score: aAssessed against generic and disease-specific questionnaires. Bone Joint Res 2012; 1(9): 225-33. doi: 10.1302\/2046-3758.19.2000076.","DOI":"10.1302\/2046-3758.19.2000076"},{"key":"167251","doi-asserted-by":"crossref","unstructured":"Gosens T, Hoefnagels N H M, De Vet R C W, Dhert W J A, Van Langelaan E J, Bulstra S K, Geesink R G T. The \u201cOxford Heup Score\u201d: the translation and validation of a questionnaire into Dutch to evaluate the results of total hip arthroplasty. Acta Orthop 2005; 76(2): 204-11. doi: 10.1080\/00016470510030580.","DOI":"10.1080\/00016470510030580"},{"key":"167252","doi-asserted-by":"crossref","unstructured":"Holmenlund C, Overgaard S, Bilberg R, Varnum C. Evaluation of the Oxford Hip Score: does it still have content validity? Interviews of total hip arthroplasty patients. Health Qual Life Outcomes 2021; 19(1): 237. doi: 10.1186\/s12955-021-01869-8.","DOI":"10.1186\/s12955-021-01869-8"},{"key":"167253","doi-asserted-by":"crossref","unstructured":"Bohm E R, Kirby S, Trepman E, Hallstrom B R, Rolfson O, Wilkinson J M, et al. Collection and reporting of patient-reported outcome measures in arthroplasty registries: multinational survey and recommendations. Clin Orthop Relat Res 2021; 479(10): 2151-66. doi: 10.1097\/CORR.0000000000001852.","DOI":"10.1097\/CORR.0000000000001852"},{"key":"167254","doi-asserted-by":"crossref","unstructured":"Ingelsrud L H, Wilkinson J M, Overgaard S, Rolfson O, Hallstrom B, Navarro R A, et al. How do patient-reported outcome scores in international hip and knee arthroplasty registries compare? Clin Orthop Relat Res 2022; 480(10): 1884-96. doi: 10.1097\/CORR.0000000000002306.","DOI":"10.1097\/CORR.0000000000002306"},{"key":"167255","doi-asserted-by":"crossref","unstructured":"Mokkink L W, de Vet H C W, Prinsen C A C, Patrick D L, Alonso J, Bouter L M, et al. COSMIN risk of bias checklist for systematic reviews of patient-reported outcome measures. Qual Life Res 2018; 27(5): 1171-9. doi: 10.1007\/s11136-017-1765-4.","DOI":"10.1007\/s11136-017-1765-4"},{"key":"167256","doi-asserted-by":"crossref","unstructured":"Svetina D, Rutkowski L, Rutkowski D. Multiple-group invariance with categorical outcomes using updated guidelines: an illustration using mplus and the lavaan\/semtools packages. Struct Equ Model 2020; 27(1): 111-30. doi: 10.1080\/10705511.2019.1602776","DOI":"10.1080\/10705511.2019.1602776"},{"key":"167257","doi-asserted-by":"crossref","unstructured":"Murray D W, Fitzpatrick R, Rogers K, Pandit H, Beard D J, Carr A J, et al. The use of the Oxford hip and knee scores. J Bone Joint Surg Br 2007; 89: 1010-14. doi: 10.1302\/0301-620X.89B8.19424.","DOI":"10.1302\/0301-620X.89B8.19424"},{"key":"167258","doi-asserted-by":"crossref","unstructured":"van Schuur W H. Mokken Scale analysis: Between the Guttman scale and parametric item response theory. Polit Anal 2003; 11(2): 139-63. doi: 10.1093\/pan\/mpg002.","DOI":"10.1093\/pan\/mpg002"},{"key":"167259","doi-asserted-by":"crossref","unstructured":"Christensen K B, Makransky G, Horton M. Critical values for Yen\u2019s Q3: identification of local dependence in the Rasch model using residual correlations. Appl Psychol Meas 2017; 41(3): 178-94. doi: 10.1177\/0146621616677520.","DOI":"10.1177\/0146621616677520"},{"key":"167260","doi-asserted-by":"crossref","unstructured":"Hu L T, Bentler P M. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model 1999; 6(1): 1-55. doi: 10.1080\/10705519909540118.","DOI":"10.1080\/10705519909540118"},{"key":"167261","doi-asserted-by":"crossref","unstructured":"Teresi J A, Fleishman J A. Differential item functioning and health assessment. Qual Life Res 2007; 16(Suppl 1): 33-42. doi: 10.1007\/s11136-007-9184-6.","DOI":"10.1007\/s11136-007-9184-6"},{"key":"167262","doi-asserted-by":"crossref","unstructured":"Harrison C J, Plessen C Y, Liegl G, Rodrigues J N, Sabah S A, Beard D J, et al. Item response theory assumptions were adequately met by the Oxford hip and knee scores. J Clin Epidemiol 2023; 158: 166-76. doi: 10.1016\/j.jclinepi.2023.04.008.","DOI":"10.1016\/j.jclinepi.2023.04.008"},{"key":"167263","doi-asserted-by":"crossref","unstructured":"Harris K, Dawson J, Doll H, Field R E, Murray D W, Fitzpatrick R, et al. Can pain and function be distinguished in the Oxford Knee Score in a meaningful way? An exploratory and confirmatory factor analysis. Qual Life Res 2013; 22: 2561-8. doi: 10.1007\/s11136-013-0393-x.","DOI":"10.1007\/s11136-013-0393-x"},{"key":"167264","doi-asserted-by":"crossref","unstructured":"Shi D, Maydeu-Olivares A, Rosseel Y. Assessing fit in ordinal factor analysis models: SRMR vs. RMSEA. Struct Equ Model 2020; 27(1): 1\u201315. doi: 10.1080\/10705511.2019.1611434.","DOI":"10.1080\/10705511.2019.1611434"},{"key":"167265","unstructured":"Embretson S E, Reise S P. Item response theory for psychologists. New York: Psychology Press; 2000. Available from: https:\/\/www.taylorfrancis.com\/books\/mono\/10.4324\/9781410605269\/item-response-theory-susan-embretson-steven-reise"},{"key":"167266","doi-asserted-by":"crossref","unstructured":"Terwee C B, Prinsen C A C, Chiarotto A, Westerman M J, Patrick D L, Alonso J, et al. COSMIN methodology for evaluating the content validity of patient-reported outcome measures: a Delphi study. Qual Life Res 2018; 27(5): 1159-70. doi: 10.1007\/s11136-018-1829-0.","DOI":"10.1007\/s11136-018-1829-0"}],"container-title":["Acta Orthopaedica"],"original-title":[],"link":[{"URL":"https:\/\/actaorthop.org\/actao\/article\/download\/46545\/55291","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaorthop.org\/actao\/article\/download\/46545\/55334","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaorthop.org\/actao\/article\/download\/46545\/55335","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaorthop.org\/actao\/article\/download\/46545\/55291","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:09:30Z","timestamp":1788433770000},"score":1,"resource":{"primary":{"URL":"https:\/\/actaorthop.org\/actao\/article\/view\/46545"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":25,"URL":"https:\/\/doi.org\/10.2340\/17453674.2026.46545","relation":{},"ISSN":["1745-3682","1745-3674"],"issn-type":[{"value":"1745-3682","type":"electronic"},{"value":"1745-3674","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,3]]}}}