Skip to main content
SpringerLink
Log in

Joint awareness in osteoarthritis of the hip and knee evaluated with the ‘Forgotten Joint’ Score before and after joint replacement

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

Abstract

Purpose

To utilize the ‘Forgotten Joint’ Score (FJS), a 12-item questionnaire analysing the ability to forget the joint, for comparing preoperative status in osteoarthritic patients scheduled for total hip arthroplasty (THA) or total knee arthroplasty (TKA). Higher scores represent a better result with a maximum of 100. The hypothesis of this study was that a preoperative difference in favour of hip arthritis could eventually explain why THA is cited more often as a forgotten joint than TKA.

Methods

A prospective cohort study was conducted in 150 patients with either tricompartmental knee (n = 75) or hip osteoarthritis (n = 75). Patients completed FJS-12 scores preoperatively and 1 year postoperatively.

Results

A similar preoperative FJS-12 was observed for hip (22 (15)) and knee osteoarthritis (24 (17)) (n.s.). The postoperative FJS-12 score was significantly higher for THA (80 (24)) than for TKA (70 (27)) (p < 0.05). High reliability after 6 weeks was observed for the preoperative FJS-12 test–retest reliability (ICC = 0.87) in TKA. A preoperative floor effect of 15 % in THA and 0 % in TKA was found as well as a postoperative ceiling effect of 33 % in THA and 9 % in TKA.

Conclusions

The clinical relevance of utilizing the FJS-12 as an instrument to evaluate outcome is strongly proposed for knee arthroplasty. In general, one is not aware of a healthy joint during the ADL, and it can therefore be regarded as ‘forgotten’. The preoperative FJS-12 Score is a powerful tool to provide patients with clearer insights into their positive evolution after surgery. The use of the FJS-12 in THA is a topic for further research, as this study found that floor and ceiling effects limit its usefulness in studies evaluating clinical outcome in this area.

Level of evidence

II.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Becker R, Doring C, Denecke A, Brosz M (2011) Expectation, satisfaction and clinical outcome of patients after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 19(9):1433–1441

    Article  PubMed  Google Scholar 

  2. Behrend H, Giesinger K, Giesinger JM, Kuster MS (2012) The “forgotten joint” as the ultimate goal in joint arthroplasty: validation of a new patient-reported outcome measure. J Arthroplasty 27(3):430–436 e431

    Article  PubMed  Google Scholar 

  3. Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD (2010) Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res 468(1):57–63

    Article  PubMed  Google Scholar 

  4. Bullens PH, van Loon CJ, de Waal Malefijt MC, Laan RF, Veth RP (2001) Patient satisfaction after total knee arthroplasty: a comparison between subjective and objective outcome assessments. J Arthroplasty 16(6):740–747

    Article  CAS  PubMed  Google Scholar 

  5. Collins NJ, Roos EM (2012) Patient-reported outcomes for total hip and knee arthroplasty: commonly used instruments and attributes of a “good” measure. Clin Geriatr Med 28(3):367–394

    Article  PubMed  Google Scholar 

  6. Davis AM, Perruccio AV, Canizares M, Hawker GA, Roos EM, Maillefert JF, Lohmander LS (2009) Comparative, validity and responsiveness of the HOOS-PS and KOOS-PS to the WOMAC physical function subscale in total joint replacement for osteoarthritis. Osteoarthr Cartil 17(7):843–847

    Article  CAS  PubMed  Google Scholar 

  7. Dawson J, Fitzpatrick R, Murray D, Carr A (1998) Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br 80(1):63–69

    Article  CAS  PubMed  Google Scholar 

  8. Giesinger JM, Kuster MS, Holzner B, Giesinger K (2013) Development of a computer-adaptive version of the Forgotten Joint Score. J Arthroplasty 28(3):418–422

    Article  PubMed  PubMed Central  Google Scholar 

  9. Giesinger K, Hamilton DF, Jost B, Holzner B, Giesinger JM (2014) Comparative responsiveness of outcome measures for total knee arthroplasty. Osteoarthr Cartil 22(2):184–189

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14

    PubMed  Google Scholar 

  11. Janse AJ, Gemke RJ, Uiterwaal CS, van der Tweel I, Kimpen JL, Sinnema G (2004) Quality of life: patients and doctors don’t always agree: a meta-analysis. J Clin Epidemiol 57(7):653–661

    Article  CAS  PubMed  Google Scholar 

  12. Jones CA, Voaklander DC, Johnston DW, Suarez-Almazor ME (2001) The effect of age on pain, function, and quality of life after total hip and knee arthroplasty. Arch Intern Med 161(3):454–460

    Article  CAS  PubMed  Google Scholar 

  13. Ko Y, Lo NN, Yeo SJ, Yang KY, Yeo W, Chong HC, Thumboo J (2013) Comparison of the responsiveness of the SF-36, the Oxford Knee Score, and the knee society clinical rating system in patients undergoing total knee replacement. Qual Life Res 22(9):2455–2459

    Article  PubMed  Google Scholar 

  14. Kwon SK, Kang YG, Kim SJ, Chang CB, Seong SC, Kim TK (2010) Correlations between commonly used clinical outcome scales and patient satisfaction after total knee arthroplasty. J Arthroplasty 25(7):1125–1130

    Article  PubMed  Google Scholar 

  15. Moreland JR, Bassett LW, Hanker GJ (1987) Radiographic analysis of the axial alignment of the lower extremity. J Bone Joint Surg Am 69(5):745–749

    CAS  PubMed  Google Scholar 

  16. Nilsdotter A, Lohmander L, Klassbo M, Roos E (2003) Hip disability and Osteoarthritis Outcome Score (HOOS)–validity and responsiveness in total hip replacement. BMC Musculoskelet Disord 4:10

    Article  PubMed  PubMed Central  Google Scholar 

  17. Noble PC, Conditt MA, Cook KF, Mathis KB (2006) The John Insall Award: patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res 452:35–43

    Article  PubMed  Google Scholar 

  18. Noble PC, Gordon MJ, Weiss JM, Reddix RN, Conditt MA, Mathis KB (2005) Does total knee replacement restore normal knee function? Clin Orthop Relat Res 431:157–165

    Article  PubMed  Google Scholar 

  19. Noble PC, Scuderi GR, Brekke AC, Sikorskii A, Benjamin JB, Lonner JH, Chadha P, Daylamani DA, Scott WN, Bourne RB (2012) Development of a new knee society scoring system. Clin Orthop Relat Res 470(1):20–32

    Article  PubMed  Google Scholar 

  20. Parsley BS, Bertolusso R, Harrington M, Brekke A, Noble PC (2010) Influence of gender on age of treatment with TKA and functional outcome. Clin Orthop Relat Res 468(7):1759–1764

    Article  PubMed  PubMed Central  Google Scholar 

  21. Roos EM, Lohmander LS (2003) The knee injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes 1:64

    Article  PubMed  PubMed Central  Google Scholar 

  22. Roos EM, Toksvig-Larsen S (2003) Knee injury and Osteoarthritis Outcome Score (KOOS)—validation and comparison to the WOMAC in total knee replacement. Health Qual Life Outcomes 1:17

    Article  PubMed  PubMed Central  Google Scholar 

  23. Soderman P, Malchau H (2001) Is the Harris hip score system useful to study the outcome of total hip replacement? Clin Orthop Relat Res 384:189–197

    Article  PubMed  Google Scholar 

  24. Stucki G, Sangha O, Stucki S, Michel BA, Tyndall A, Dick W, Theiler R (1998) Comparison of the WOMAC (Western Ontario and McMaster Universities) osteoarthritis index and a self-report format of the self-administered Lequesne–Algofunctional index in patients with knee and hip osteoarthritis. Osteoarthr Cartil 6(2):79–86

    Article  CAS  PubMed  Google Scholar 

  25. Suda AJ, Seeger JB, Bitsch RG, Krueger M, Clarius M (2010) Are patients’ expectations of hip and knee arthroplasty fulfilled? A prospective study of 130 patients. Orthopedics 33(2):76–80

    Article  PubMed  Google Scholar 

  26. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC (2007) Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 60(1):34–42

    Article  PubMed  Google Scholar 

  27. Thienpont E, Opsomer G, Koninckx A, Houssiau F (2014) Joint awareness in different types of knee arthroplasty evaluated with the Forgotten Joint Score. J Arthroplasty 29(1):48–51

    Article  PubMed  Google Scholar 

  28. Thienpont E, Zorman D (2015) Higher Forgotten Joint Score for fixed-bearing than for mobile-bearing total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-015-3663-z

    Google Scholar 

  29. Thompson SM, Salmon LJ, Webb JM, Pinczewski LA, Roe JP (2015) Construct validity and test re-test reliability of the Forgotten Joint Score. J Arthroplasty. doi:10.1016/j.arth.2015.05.001

    Google Scholar 

  30. Williams VJ, Piva SR, Irrgang JJ, Crossley C, Fitzgerald GK (2012) Comparison of reliability and responsiveness of patient-reported clinical outcome measures in knee osteoarthritis rehabilitation. J Orthop Sports Phys Ther 42(8):716–723

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author’s contribution

All authors participated in the study design and helped outline the manuscript. TE and CO drafted the manuscript. VA and PES coordinated the data collection and literature search. JPF helped with the design of the study and corrected the manuscript. All authors read and approved the final version.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, University Hospital Saint Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium

    E. Thienpont, A. Vanden Berghe, P. E. Schwab & O. Cornu

  2. Department of Orthopaedic Surgery, CHU Ambroise Paré, Mons, Belgium

    J. P. Forthomme

Authors
  1. E. Thienpont
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Vanden Berghe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. E. Schwab
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. P. Forthomme
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. O. Cornu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E. Thienpont.

Ethics declarations

Conflict of interest

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Thienpont, E., Vanden Berghe, A., Schwab, P.E. et al. Joint awareness in osteoarthritis of the hip and knee evaluated with the ‘Forgotten Joint’ Score before and after joint replacement. Knee Surg Sports Traumatol Arthrosc 24, 3346–3351 (2016). https://doi.org/10.1007/s00167-015-3970-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-015-3970-4

Keywords

Search

Navigation