Evaluation of joint awareness after acetabular fracture: Validation of the Forgotten Joint Score according to the COSMIN checklist protocol

Abstract

BACKGROUND A fracture of the acetabulum is an uncommon, but serious injury. Established outcome tools do not reflect the patient’s perspective after fracture of the hip joint. Originally designed for post-arthroplasty patients, the Forgotten Joint Score (FJS) is a patient-reported outcome measurement (PROM) tool evaluating the disease-specific health-related quality of life (HR-QoL). AIM To validate the FJS in patients after acetabular fracture. METHODS In a prospective mono-centric cohort study, we evaluated 100 patients at mean 5.2 ± 3.6 years after a fracture of the acetabulum. The validation study followed the complete COSMIN checklist protocol. For calculation of convergent validity, we used the Tegner-Activity Scale, the Western Ontario and McMaster Universities Osteoarthritis Index, the EuroQol-5D, and a subjective rating of change as an anchor variable. RESULTS We confirmed good internal consistency with a Cronbach‘s alpha of 0.95. With an intraclass correlation coefficient of 0.99 (95%CI: 0.97, 0.99), test-retest reliability of the FJS was excellent. Correlation coefficients between the questionnaires were moderate to high ranging from |0.56| to |0.83| (absolute value). No relevant floor or ceiling effects occurred. Standard error of measurement was 3.2 and smallest detectable change (SDC) was 8.8. Thus, changes greater than 8.8 points between two assessments denote a real change in FJS. CONCLUSION The FJS is a valid and reliable tool for evaluation of patient-reported outcome in posttraumatic condition after acetabular fracture. The SDC indicating a real clinical improvement was 8.8 points in the FJS. We could confirm responsiveness of the FJS and found no relevant floor- or ceiling effects.

Traditional Chinese-Hong Kong version of Forgotten Joint Score-12 (FJS-12) for patients with osteoarthritis of the knee underwent joint replacement surgery: cross-cultural and sub-cultural adaptation, and validation

“…The effect of BMI on results from different PRO questionnaires are somehow conflicting [51][52][53]. FJS-12 has been proven to be simple, valid and reliable in original and translated versions [3,17,20,[54][55][56]. A study in New York found that although patients who were obese (BMI ≥ 30 kg/m 2 ) and received primary TKA provided lower post-surgery FJS-12 scores, statistical significance was not found [57].…”

“…FJS-12 is based upon the assumption that the goal of total knee arthroplasty is a joint patient can “forget” about. Studies started using FJS-12 as the sole PRO assessment tool [ 19 , 20 ] to access knee functions and used to assess the long-term results after TKA [ 21 ].…”

Imaging, post-processing and navigation: Surgical applications in pelvic fracture treatment

“…Therefore, surgeons must undergo a specific training for years for specialization in pelvic surgery. Technical advancements in imaging and surgical instruments may lower the learning curve and lead to better surgical results [7][8][9][10][11][12] . Historically, treatment of pelvic fractures was open reduction and plate osteosynthesis of the pelvic ring.…”