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Cacchio A.,University of LAquila | De Paulis F.,Valle Giulia Clinic | Maffulli N.,Center for Sports and Exercise Medicine Barts
British Journal of Sports Medicine | Year: 2014

Background There is a need for a patient-reported outcome (PRO) questionnaire to evaluate patients with proximal hamstring tendinopathy (PHT). Objective To develop a PRO questionnaire based on VISA questionnaire forms for patients with PHT. Methods Item generation, item reduction, item scaling and evaluation of the psychometric properties were used to develop a questionnaire to assess the severity of symptoms, function and ability to play sports in patients with PHT and healthy subjects. The final version, named Victorian Institute of Sport Assessment-Proximal Hamstring Tendons (VISA-H), consisted of eight questions that measured the domains of pain, function and sporting activity. The psychometric properties of a questionnaire were estimated in a population of nonsurgical (n=20) and surgical (n=10) patients, as well as in healthy subjects (n=30). Results The VISA-H questionnaire displayed a high degree of internal consistency, with a Cronbach α of 0.84. (The test-retest reliability was high for all groups of participants with an intraclass correlation coefficient ranging from 0.90 to 0.95.) The VISA-H exhibited a high correlation with the Nirschl phase rating scale (r ranging from .0.75 to .0.89) and a generic tendon grading system proposed by Curwin and Stanish (r ranging from -0.70 to -0.88). Also, the responsiveness was higher for the VISA-H questionnaire with an area under the curve of 0.90 and a minimum clinically important difference of 22 points. Conclusions The VISA-H is a PRO questionnaire with high psychometric properties for measuring pain, function and sporting activity in patients with PHT.

Rocco P.,Biomedical University of Rome | Lorenzo D.B.,Biomedical University of Rome | Guglielmo T.,Biomedical University of Rome | Michele P.,Biomedical University of Rome | And 3 more authors.
British Medical Bulletin | Year: 2016

Introduction Cartilage debridement is one of the recommended procedures for the management of chondral defects. Radiofrequency probes allow to debride the cartilage, but may induce subchondral bone necrosis. Sources of data Medline, Cochrane and Google Scholar were searched to identify studies on arthroscopic debridement of the articular cartilage of the knee using radiofrequency chondroplasty. The methodological quality of the studies was assessed using the Coleman methodology score (CMS). Areas of agreement Monopolar and bipolar radiofrequency devices provide significantly better clinical outcomes, especially for patients with high-grade chondral lesions, compared with mechanical shaver only. Despite the original concerns regarding subchondral bone necrosis, low complication rates are reported. Areas of controversy Heterogeneity in terms of type of device does not allow sound comparison of the published results. There is lack of evidence on the long-Term effects of radiofrequency chondroplasty. Growing points Study methodology should be improved: The average Coleman methodology score was 56.2 out of 100. Research More comparative, well-designed and larger cohort trials are needed to ascertain whether radiofrequency chondroplasty offers long-Term benefits over other simpler and more economical alternatives. © 2016 The Author 2016. Published by Oxford University Press.

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