Changes and thresholds in the Forgotten Joint Score after total hip arthroplasty

Aims The aim of this study was to identify the minimal clinically important difference (MCID), minimal important change (MIC), minimal detectable change (MDC), and patient-acceptable symptom state (PASS) in the Forgotten Joint Score (FJS) according to patient satisfaction six months following total hip arthroplasty (THA) in a UK population. Methods During a one-year period, 461 patients underwent a primary THA and completed preoperative and six-month FJS, with a mean age of 67.2 years (22 to 93). At six months, patient satisfaction was recorded as very satisfied, satisfied, neutral, dissatisfied, or very dissatisfied. The difference between patients recording neutral (n = 31) and satisfied (n = 101) was used to define the MCID. MIC for a cohort was defined as the change in the FJS for those patients declaring their outcome as satisfied, whereas receiver operating characteristic curve analysis was used to determine the MIC for an individual and the PASS. Distribution-based methodology was used to calculate the MDC. Results Using satisfaction as the anchor, the MCID for the FJS was 8.1 (95% confidence interval (CI) 3.7 to 15.9; p = 0.040), which was affirmed when adjusting for confounding. The MIC for the FJS for a cohort of patients was 17.7 (95% CI 13.7 to 21.7) and for an individual patient was 18. The MDC90 for the FJS was eight, meaning that 90% of patients scoring more than this will have experienced a real change that is beyond measurement error. The PASS threshold for the FJS was defined as 29. Conclusion The MCID and MIC can be used respectively to assess whether there is a clinical difference between two groups, or whether a cohort or patient has had a meaningful change in their FJS. Both values were greater than measurement error (MDC90), suggesting a real change. The PASS threshold for the postoperative FJS can be used as a marker of achieving patient satisfaction following THA. Cite this article: Bone Joint J 2021;103-B(12):1759–1765.

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A Comparative Analysis of Patient Satisfaction following Total Knee Arthroplasty and Total Hip Arthroplasty Using the Forgotten Joint Score

The Journal of Hip Surgery ◽

10.1055/s-0040-1712523 ◽

2020 ◽

Vol 04 (02) ◽

pp. 084-089

Author(s):

Vivek Singh ◽

Stephen Zak ◽

Ran Schwarzkopf ◽

Roy Davidovitch

Keyword(s):

Total Knee Arthroplasty ◽

Patient Satisfaction ◽

Total Hip Arthroplasty ◽

Knee Arthroplasty ◽

Hip Arthroplasty ◽

Demographic Data ◽

Demographic Differences ◽

Total Hip ◽

Forgotten Joint Score ◽

Total Knee

AbstractMeasuring patient satisfaction and surgical outcomes following total joint arthroplasty remains controversial with most tools failing to account for both surgeon and patient satisfaction in regard to outcomes. The purpose of this study was to use “The Forgotten Joint Score” questionnaire to assess clinical outcomes comparing patients who underwent a total hip arthroplasty (THA) with those who underwent a total knee arthroplasty (TKA). We conducted a retrospective review of patients who underwent primary THA or TKA between September 2016 and September 2019 and responded to the Forgotten Joint Score-12 (FJS-12) questionnaire at least at one of three time periods (3, 12, and 21 months), postoperatively. An electronic patient rehabilitation application was used to administer the questionnaire. Collected variables included demographic data (age, gender, race, body mass index [BMI], and smoking status), length of stay (LOS), and FJS-12 scores. t-test and chi-square were used to determine significance. Linear regression was used to account for demographic differences. A p-value of less than 0.05 was considered statistically significant. Of the 2,359 patients included in this study, 1,469 underwent a THA and 890 underwent a TKA. Demographic differences were observed between the two groups with the TKA group being older, with higher BMI, higher American Society of Anesthesiologists scores, and longer LOS. Accounting for the differences in demographic data, THA patients consistently had higher scores at 3 months (53.72 vs. 24.96; p < 0.001), 12 months (66.00 vs. 43.57; p < 0.001), and 21 months (73.45 vs. 47.22; p < 0.001). FJS-12 scores for patients that underwent THA were significantly higher in comparison to TKA patients at 3, 12, and 21 months postoperatively. Increasing patient age led to a marginal increase in FJS-12 score in both cohorts. With higher FJS-12 scores, patients who underwent THA may experience a more positive evolution with their surgery postoperatively than those who had TKA.

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Excellent Functional Outcome and Quality of Life after Primary Cementless Total Hip Arthroplasty (THA) Using an Enhanced Recovery Setup

Journal of Clinical Medicine ◽

10.3390/jcm10040621 ◽

2021 ◽

Vol 10 (4) ◽

pp. 621

Author(s):

Franziska Leiss ◽

Julia Sabrina Götz ◽

Günther Maderbacher ◽

Matthias Meyer ◽

Jan Reinhard ◽

...

Keyword(s):

Quality Of Life ◽

Patient Satisfaction ◽

Total Hip Arthroplasty ◽

Functional Outcome ◽

Hip Arthroplasty ◽

Enhanced Recovery ◽

Harris Hip Score ◽

Total Hip ◽

Cementless Total Hip Arthroplasty

Background: Total hip arthroplasty combined with the concept of enhanced recovery is of continued worldwide interest, as it is reported to improve early functional outcome and treatment quality without increasing complications. The aim of the study was to investigate functional outcome and quality of life 4 weeks and 12 months after cementless total hip arthroplasty in combination with an enhanced recovery concept. Methods: A total of 109 patients underwent primary cementless Total Hip Arthroplasty (THA) in an enhanced recovery concept and were retrospectively analyzed. After 4 weeks and 12 months, clinical examination was analyzed regarding function, pain and satisfaction; results were evaluated using Harris Hip score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EQ-5D-5L, EQ-VAS and subjective patient-related outcome measures (PROMs). Preoperatively, HADS (Hospital Anxiety and Depression Scale) was collected. A correlation analysis of age, American Society of Anesthesiologists (ASA), HADS and comorbidities (diabetes mellitus, art. hypertension, cardiovascular disease) with WOMAC, Harris Hip score (HHS) and EQ-5D was performed. Results: Patients showed a significant improvement in Harris Hip score 4 weeks and 12 months postoperatively (p < 0.001). WOMAC total score, subscale pain, subscale stiffness and subscale function improved significantly from preoperative to 12 months postoperative (p < 0.001). EQ-5D showed a significant improvement preoperative to postoperative (p < 0.001). The influence of anxiety or depression (HADS-A or HADS-D) on functional outcome could not be determined. There was a high patient satisfaction postoperatively, and almost 100% of patients would choose enhanced recovery surgery again. Conclusion: Cementless THA with the concept of enhanced recovery improves early clinical function and quality of life. PROMs showed a continuous improvement over a follow-up of 12 months after surgery. PROMs can help patients and surgeons to modify expectations and improve patient satisfaction.

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Total Hip Arthroplasty: Minimal Clinically Important Difference and Patient Acceptable Symptom State for the Forgotten Joint Score 12

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052267 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2267

Author(s):

Umile Giuseppe Longo ◽

Sergio De Salvatore ◽

Ilaria Piergentili ◽

Anna Indiveri ◽

Calogero Di Naro ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Validity And Reliability ◽

Total Hip ◽

Forgotten Joint Score ◽

Post Surgery ◽

Clinically Important Difference ◽

Patient Reported ◽

Patient Acceptable Symptom State

The Forgotten Joint Score-12 (FJS-12) is a valid patient-reported outcome measures (PROMs) used to assess prosthesis awareness during daily activities after total hip arthroplasty (THA). The minimum clinically important difference (MCID) can be defined as the smallest change or difference that is evaluated as beneficial and could change the patient’s clinical management. The patient acceptable symptom state (PASS) is considered the minimum PROMs cut-off value that corresponds to a patient’s satisfactory state of health. Despite the validity and reliability of the FJS-12 having been already demonstrated, the MCID and the PASS of this score have not previously been defined. Patients undergoing THA from January 2019 to October 2019 were assessed pre-operatively and six months post-surgery using the FJS-12, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Oxford Hip Score (OHS). Pre-operative and follow-up questionnaires were completed by 50 patients. Both distribution-based approaches and anchor approaches were used to estimate MCID. The aim of this paper was to assess the MCID and PASS values of FJS-12 after total hip replacement. The FJS-12 MCID from baseline to 6 months post-operative follow-up was 17.5. The PASS calculated ranged from 69.8 to 91.7.

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Patient Satisfaction After Total Hip Arthroplasty Is Not Influenced by Reductions in Opioid Prescribing

The Journal of Arthroplasty ◽

10.1016/j.arth.2021.02.009 ◽

2021 ◽

Author(s):

David A. Bloom ◽

Amit K. Manjunath ◽

Anthony P. Gualtieri ◽

Jordan W. Fried ◽

Ran M. Schwarzkopf ◽

...

Keyword(s):

Patient Satisfaction ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Total Hip ◽

Opioid Prescribing

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Comparison of Patient Satisfaction with Incision Cosmesis After Standard and Minimally Invasive Total Hip Arthroplasty

Orthopedics ◽

10.3928/01477447-20080401-11 ◽

2008 ◽

Vol 31 (4) ◽

pp. 1-5 ◽

Cited By ~ 7

Author(s):

Wayne M. Goldstein ◽

Rose Ali ◽

Jill Jasperson Branson ◽

Kimberly A. Berland

Keyword(s):

Patient Satisfaction ◽

Total Hip Arthroplasty ◽

Minimally Invasive ◽

Hip Arthroplasty ◽

Total Hip

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Patient Satisfaction Reporting After Total Hip Arthroplasty: A Systematic Review

Orthopedics ◽

10.3928/01477447-20170120-04 ◽

2017 ◽

Vol 40 (3) ◽

pp. e400-e404 ◽

Cited By ~ 12

Author(s):

Cynthia A. Kahlenberg ◽

Benedict U. Nwachukwu ◽

William W. Schairer ◽

Michael E. Steinhaus ◽

Michael B. Cross

Keyword(s):

Systematic Review ◽

Patient Satisfaction ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Total Hip

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Excellent results of large-diameter ceramic-on-ceramic bearings in total hip arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.100b11.bjj-2018-0532.r1 ◽

2018 ◽

Vol 100-B (11) ◽

pp. 1434-1441 ◽

Cited By ~ 20

Author(s):

W. G. Blakeney ◽

Y. Beaulieu ◽

B. Puliero ◽

M. Lavigne ◽

A. Roy ◽

...

Keyword(s):

Patient Satisfaction ◽

Total Hip Arthroplasty ◽

Acetabular Component ◽

Hip Arthroplasty ◽

Short Form ◽

Large Diameter ◽

Ucla Activity Score ◽

Total Hip ◽

Ceramic On Ceramic

Aims This study reports the mid-term results of total hip arthroplasty (THA) performed using a monoblock acetabular component with a large-diameter head (LDH) ceramic-on-ceramic (CoC) bearing. Patients and Methods Of the 276 hips (246 patients) included in this study, 264 (96%) were reviewed at a mean of 67 months (48 to 79) postoperatively. Procedures were performed with a mini posterior approach. Clinical and radiological outcomes were recorded at regular intervals. A noise assessment questionnaire was completed at last follow-up. Results There were four re-operations (1%) including one early revision for insufficient primary fixation (0.4%). No hip dislocation was reported. The mean University of California, Los Angeles (UCLA) activity score, 12-Item Short-Form Health Survey (SF-12) Mental Component Summary (MCS) score, SF-12 Physical Component Summary (PCS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and Forgotten Joint Score (FJS) were 6.6 (2 to 10), 52.8 (25.5 to 65.7), 53.0 (27.2 to 66.5), 7.7 (0 to 63), and 88.5 (23 to 100), respectively. No signs of loosening or osteolysis were observed on radiological review. The incidence of squeaking was 23% (n = 51/225). Squeaking was significantly associated with larger head diameter (p < 0.001), younger age (p < 0.001), higher SF-12 PCS (p < 0.001), and UCLA scores (p < 0.001). Squeaking did not affect patient satisfaction, with 100% of the squeaking hips satisfied with the surgery. Conclusion LDH CoC THAs have demonstrated excellent functional outcomes at medium-term follow-up, with very low revision rate and no dislocations. The high incidence of squeaking did not affect patient satisfaction or function. LDH CoC with a monoblock acetabular component has the potential to provide long term implant survivorship with unrestricted activity, while avoiding implant impingement, liner fracture at insertion, and hip instability. Cite this article: Bone Joint J 2018;100-B:1434–41.

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