The Hôtel-Dieu de France is one of the three leading Lebanese medical centers. It is located on Alfred Naccache Boulevard in Beirut, and is the oldest active French hospital in the city.Hôtel-Dieu, literally "hostel of God," is an archaic French term for hospital, referring to the origins of hospitals as religious institutions..
Abstract Background The Knee injury and Osteoarthritis Outcome Score-12 (KOOS-12) is a widely used patient-reported outcome measure assessing pain, function, and quality of life (QOL) in individuals with knee osteoarthritis or injury. However, the absence of validated short-form knee instruments in Arabic necessitates cross-cultural adaptation. Methods A prospective cross-sectional validation of the Arabic KOOS-12 (KOOS-12 AR) was conducted following established guidelines for translation and adaptation (independent forward translations, reconciliation, blinded back-translation, expert review, pilot testing, and proofreading). Adults > 40 years with knee osteoarthritis were consecutively recruited from two outpatient clinics and completed the KOOS-12 AR and the validated Arabic WOMAC (WOMAC-AR). A total of 201 patients were enrolled, and a clinically stable subset of 91 participants (the retest subgroup) completed a retest after 5–10 days. Psychometric evaluation included interpretability, internal consistency (Cronbach’s α), test–retest reliability using intraclass correlation coefficients (ICC(2,1)), and measurement error indices such as standard error of measurement (SEM), minimal detectable change (MDC), and content, structural, and convergent validity. Results Internal consistency was excellent across domains (Cronbach’s α = 0.93). Test–retest reliability was likewise excellent (ICC(2,1) = 0.990 for Pain, 0.992 for Function, 0.989 for QOL, and 0.987 for the Total score). SEM values were small (2.1–2.3 points), yielding MDC_individual ≈6 points across subscales. Bland–Altman analyses showed minimal bias (−0.36 to −0.02) and narrow limits of agreement (approximately ± 6–7 points). Structural validity was supported by principal component analysis (PCA): each subscale demonstrated a clear one-factor solution (Pain eigenvalue 2.50, 62.5% variance; Function 2.72, 67.9%; QOL 2.48, 62.1%). When all 12 items were analyzed together, the dominant first component explained 50.6% of total variance (Kaiser–Meyer–Olkin (KMO) = 0.91). Convergent validity with WOMAC-AR was strong, with Spearman’s ρ = 0.879 for total scores (p < 0.0001). Conclusion The KOOS-12 AR demonstrated excellent reliability, validity, structural coherence, and measurement reproducibility. It represents a robust, culturally appropriate, and feasible instrument for evaluating knee pain, function, and QOL among Arabic-speaking patients.
Previous meta-analyses have shown that systematic deltoid repair (DR) in patients with bimalleolar equivalent ankle fractures improves post-operative functional outcomes and reduces reoperations. However, these studies were retrospective and are subject to the biases inherent in the nature of observational studies. Therefore, by including only randomized controlled trials (RCTs), this meta-analysis will assess the benefits of DR in these patients. Following the PRISMA guidelines, PubMed, Embase, Cochrane, and Google Scholar were accessed and explored until November 2025. The extracted data consisted of the risk of complications, post-operative and improvement in medial clear space (MCS), operative time, post-operative pain and post-operative American Orthopedic Foot and Ankle Society (AOFAS) score. Five RCTs were included, consisting of 244 patients, with 121 in the DR group and 123 in the control group. There was no difference between the two groups in adverse events. In addition, there were no differences in post-operative MCS, pain, or AOFAS between the two groups. However, the control group had a shorter operative time (Mean Difference = 46.75 min, p = 0.05). The results of this meta-analysis revealed that systematic DR did not have additional benefits in patients with bimalleolar equivalent ankle fractures. Future studies are needed in order to figure out the characteristics of patients that benefit from DR in this type of ankle fractures.
