New work from The American Hip Institute in Des Plaines, Illinois has determined that the Forgotten Joint Score (FJS) is extremely accurate when it comes to demonstrating success following total hip arthroplasty (THA).
The study, “Can we Help Patients Forget Their Joint? Determining a Threshold for Successful Outcome for the FJS,” appears in the August 9, 2019 edition of The Journal of Arthroplasty.
Co-author Benjamin Domb, M.D., founder and Chair of the American Hip Institute Research Foundation explained the genesis of the Forgotten Joint Score and how it works to OTW, “The Forgotten Joint Score was proposed by Behrend and colleagues in 2012 as a patient-reported outcome (PRO) that would gauge the subjective ability of a patient to ‘forget their joint’ in everyday activities.”
“The primary goal of joint arthroplasty is to provide a natural feeling joint that the patient can enjoy in everyday life. The ‘ceiling effect’ of older patient-reported outcomes hampered their ability to assess how successful surgery was.
The Forgotten Joint Score was used to minimize the ‘ceiling effect’—allowing us to differentiate between ‘good’ and ‘great.’”
For this study, the research team performed a retrospective analysis of 247 individuals who underwent primary THA between December 2012 and April 2017.
According to Dr. Domb, “One of our primary missions is following the clinical outcomes of our patients. We invest time, manpower, and financial resources in collecting scores and surgical outcomes such as complications and following our patients over the years.”
“We identified the Forgotten Joint Score many years ago as a useful tool for following our THA patients. However, the score in itself is only a number, and the clinical interpretation was missing. This is something we wanted to answer—what constitutes a ‘good’ Forgotten Joint Score?”
“We were successful in determining a benchmark score for the Forgotten Joint Score—a score that correlates with a ‘successful’ operation based on data from nearly 250 patients. We determined that at 1 year the threshold score is 69, while at 2 years post-operatively it rises to 73. Based on this number, future studies which we conduct can evaluate procedures based on what proportion of patients are able to reach this benchmark. This may allow assessment of clinical significance as well as statistical significance in future studies.”
“Our study also demonstrated that only 16.2% and 23% of patients, at 1- and 2-years after surgery respectively, hit the ceiling score on the Forgotten Joint Score. We found that the average scores, as well as the number of patients achieving a successful outcome, improve between 1 and 2 years after surgery. This has not been previously shown and is a very interesting and important finding of this study.”
“The ceiling effect is an important issue for clinicians when assessing scores. The benchmarks for Forgotten Joint Score that were identified in this study may assist researchers in distinguishing between ‘good outcomes’ and ‘great outcomes.’”
