Dongping Wan: Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, People's Republic of China.
Shihang Cao: Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, People's Republic of China.
Xinrui Li: Department of Health Statistics, Faculty of Preventive Medicine, the Air Force Military Medical University, Xi'an, People's Republic of China.
Qiang Zan: The First Clinical Medical College, Shaanxi University of Chinese Medicine, Xianyang, People's Republic of China.
Shuxin Yao: Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, People's Republic of China.
Jianbing Ma: Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, People's Republic of China.
Lei Shang: Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, People's Republic of China.
Chao Xu: Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, People's Republic of China.
Background: The High Activity Arthroplasty Score (HAAS) is a validated score that assesses functional outcomes after lower limb arthroplasty, with fewer ceiling effects than other scores. The aim is to translate and cross-culturally adapt the HAAS into a Chinese version (HAAS-C) and to evaluate the psychometric properties of HAAS-C in patients after primary total knee arthroplasty (TKA). Methods: A total of 104 patients diagnosed with knee osteoarthritis who had undergone TKA at least 12 months prior were recruited. A forward and backward translation procedure was performed for developing a culturally acceptable HAAS-C. Internal consistency was assessed using Cronbach's ��, and test-retest reliability was measured using the intraclass correlation coefficient (ICC) within a 10-day interval. Construct validity was assessed by examining the correlations between HAAS-C and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EuroQoL Group's five-dimension questionnaire (EQ-5D-5L), and Oxford knee score (OKS). Results: HAAS-C demonstrated adequate Internal consistency reliability, as indicated by Cronbach's �� coefficient of 0.75. Test-retest reliability yielded excellent results, with an ICC value of 0.98. Content validity indices were high, with a scale-level validity index of 0.9 and item-level validity indices greater than or equal to 0.8. HAAS-C showed a strong correlation with WOMAC ( = 0.69), a moderate correlation with EQ-5D-5L ( = 0.43), and OKS ( = 0.53) while exhibiting no floor or ceiling effects. Conclusion: The validated HAAS-C questionnaire is a valid instrument for assessing patients undergoing TKA in mainland China.
