Translation, cross-cultural adaptation, and validation of the Turkish version of the Hospital for Special Surgery Anterior Cruciate Ligament Postoperative Satisfaction Survey

This study aimed to translate, culturally adapt, and assess the validity and reliability of the Turkish version of the Hospital for Special Surgery Anterior Cruciate Ligament Postoperative Satisfaction Survey (HSS ACL-SS) in patients who underwent ACL reconstruction. Eighty-six patients who underwent primary ACL reconstruction were included in the study. Patient-reported outcome measures were administered during routine postoperative outpatient follow-up visits. The Turkish HSS ACL-SS, along with the Lysholm score, Tegner activity scale, International Knee Documentation Committee subjective form, and short form-36, were administered. Internal consistency was analyzed using Cronbach alpha, and test–retest reliability was assessed with the intraclass correlation coefficient and Bland–Altman plots. Construct validity was evaluated through principal component analysis with Varimax rotation and Spearman correlation with parallel scales. Floor and ceiling effects were also examined. The Cronbach alpha coefficient for the Turkish HSS ACL-SS was 0.943, indicating excellent internal consistency. The intraclass correlation coefficient was 0.975, demonstrating excellent test–retest reliability. After removing 1 nonadditive item, principal component analysis confirmed a single-factor structure for the final 9-item Turkish HSS ACL-SS, explaining 69.3% of the total variance. Very strong correlations were found with the International Knee Documentation Committee (ρ = 0.815; P < .001), strong correlations with the Lysholm (ρ = 0.681; P < .001), and moderate correlations with the Tegner (ρ = 0.347; P = .001) scores. Only the physical functioning subscale of the short form-36 showed a moderate correlation (ρ = 0.294; P = .006). No significant floor or ceiling effects were observed. The Turkish version of the HSS ACL-SS is a reliable, valid, and culturally adapted instrument for assessing patient satisfaction following ACL reconstruction.