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Rasch analysis of the Forgotten Joint Score in patients undergoing knee arthroplasty

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to test the hypothesis that the “Forgotten Joint Score” (FJS-12) is a unidimensional interval-level scale. Unidimensionality refers to measuring a single attribute, i.e., the single ability to forget the arthroplasty. If this property is not verified, the interpretation of the score can be confusing. Unidimensionality is an essential prerequisite of construct validity and required if FJS-12 response data are to be validly summated into a single score. Interval-level dimension is an essential prerequisite of the parametric statistics. Rasch analysis was used to test our study hypothesis.

Methods

The FJS-12 questionnaire was validated in 248 unilateral knee arthroplasty patients. Successive analyses were used to select items with good psychometric qualities to constitute the new “FJS”. The external validity was assessed with the KUJALA questionnaire.

Results

Quantity of relevant items was greater than 50%. Of the 12 original items, nine showed disturbed thresholds, indicating that patients were unable to discriminate among the five levels for these items. The data set was reanalyzed using a four-level scale. The new analysis indicated that the internal consistency was good (r = 0.84). Three items did not fit with the model and they were removed. The nine items of the final scale defined a unidimensional and linear measure of the forgotten joint, and showed a continuous progression in their difficulty. The perception of difficulty was group-independent. The correlation coefficient was moderate between FJS and KUJALA score (r = 0.4).

Conclusions

This new and items reduced FJS can be used in clinical practice with good psychometric qualities. It provides a reliable tool to follow up patient’s evolution and document changes related to knee arthroplasty. This valid FJS is needed in evaluating patients’ assessment, one indicator of quality of care.

Level of evidence

III—Therapeutic.

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Funding

This project is not supported by a research grant or funding source.

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Authors and Affiliations

  1. Physical Medicine and Rehabilitation Department Cotonou, National University Hospital of Cotonou, Cotonou, Benin

    Didier D. Niama Natta

  2. Neuro-musculoskeletal Lab (NMSK), Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Avenue Mounier 53, B1.53.07, 1200, Brussels, Belgium

    Emmanuel Thienpont, Alexandre Bredin, Gwenael Salaun & Christine Detrembleur

  3. Cliniques Universitaires Saint-Luc, Service d’Orthopédie et de Traumatologie de l’appareil Locomoteur, Avenue Hippocrate 10, 1200, Brussels, Belgium

    Emmanuel Thienpont

Authors
  1. Didier D. Niama Natta
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  2. Emmanuel Thienpont
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  3. Alexandre Bredin
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  4. Gwenael Salaun
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  5. Christine Detrembleur
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Contributions

All authors worked collectively to develop the protocols and methods described in this paper. DN, ET, and CD were principal investigators responsible for the fieldwork, the statistical analysis, and the writing of the manuscript. All authors contributed to the interpretation of results. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Christine Detrembleur.

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Conflict of interest

The authors declare that they have no proprietary, financial, professional, or other personal competing interests of any nature or kind.

Ethics approval

This study was conducted according to the declaration of Helsinki and had ethical approval from the Comité d’Ethique Hospitalo-Facultaire de l’Université Catholique de Louvain (B403201523492).

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Niama Natta, D.D., Thienpont, E., Bredin, A. et al. Rasch analysis of the Forgotten Joint Score in patients undergoing knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 27, 1984–1991 (2019). https://doi.org/10.1007/s00167-018-5109-x

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  • DOI: https://doi.org/10.1007/s00167-018-5109-x

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