Archives of Orthopaedic and Trauma Surgery
ARTHROSCOPY AND SPORTS MEDICINE
Translation and validation of the Simpliﬁed Chinese version
of International Knee Documentation Committee Subjective Knee
· Chen Zhang
· Yuming Zou
· Xuan Huang
· Wei‑Dong Xu
Received: 27 December 2017
© Springer-Verlag GmbH Germany, part of Springer Nature 2018
Purpose To cross-culturally adapt and validate the International Knee Documentation Committee Subjective Knee Form to
Simpliﬁed Chinese (SC-IKDC-SKF).
Methods The original version was translated and cross-culturally adapted into Simpliﬁed Chinese according to standard
guidelines. A total of 103 patients enrolled in our research. Each participant was asked to complete three instruments includ-
ing the SC-IKDC-SKF, the Lysholm knee score, and the Short Form-36 (SF-36). Each participant was asked to complete the
SC-IKDC-SKF twice with an interval of 7 days. A portion of the participants (n = 51) ﬁnished the SC-IKDC-SKF a third
time with an interval of 12 months after arthroscopic treatment. Psychometric assessments included internal consistency,
test–retest reliability, content and construct validity, and responsiveness.
Results Strong internal consistency was proved with Cronbach’s α = 0.92. The intraclass correlation coeﬃcient reached
0.94, indicating high test–retest reliability. No ceiling or ﬂoor eﬀect was observed. Compared with the Lysholm knee score
and the subscales of SF-36, good convergent and divergent validity of the SC-IKDC-SKF were demonstrated. The standard
response mean was 2.39 and the eﬀect size was 1.33, indicating high responsiveness.
Conclusions The SC-IKDC-SKF was demonstrated to be a reliable, valid and responsive instrument for evaluating knee
functions and symptoms of patients with knee pathology in mainland China.
Level of evidence II.
Keywords Knee · Validation · International Knee Documentation Subjective Knee Form · Instrument · Simpliﬁed Chinese
As the most complex joint in the human body, the knee
joint is highly prone to injury. Knee disorders including
traumatic injuries and degenerative changes are one of the
major factors leading to labor disability and work absentee-
ism in China . Knee-speciﬁc patient-reported outcomes
have been developed to assess knee functions, symptoms and
quality of life (QoL) from patients’ perspective including
Lysholm knee score, Knee injury and Osteoarthritis Out-
come Score (KOOS), the Knee Outcome Survey-activities
of daily living subscale (KOS-ADLS) [1–3]. The Interna-
tional Knee Documentation Committee Subjective Knee
Form (IKDC-SKF) was performed in 1987 and validated
in 2001 by International Knee Documentation Committee
. It has been translated and cross-culturally adapted into
Italian, Dutch, Thai, Brazilian, Chinese, Korean, Persian,
Turkish and Greek [5–13]. As a previous study reported,
IKDC-SKF is the preferred tool to assess for ligament inju-
ries of the knee .
The Traditional Chinese version of IKDC-SKF has been
reported in 2011 . The terms “Traditional Chinese” (fan-
tizi) and “Simpliﬁed Chinese” (jiantizi) are neologisms
promulgated in the middle of the twentieth century, in order
to reduce regional and interethnic diﬀerences . The
previous is widely used in Hong Kong, Taiwan, and other
Zhen-yu Jia, Chen Zhang and Yuming Zou are co-ﬁrst authors;
they contributed equally to the work.
* Xuan Huang
* Wei-Dong Xu
Department of Orthopedics, Changhai Hospital, Second
Military Medical University, Shanghai, China