Department of Orthopedic Surgery, NYU Langone Health, New York, New York.
J Arthroplasty. 2022 Aug;37(8):1557-1561. doi: 10.1016/j.arth.2022.03.069. Epub 2022 Mar 26.
In order to better understand the clinical benefits of total knee arthroplasty (TKA) and improve the interpretability of the Forgotten Joint Score (FJS-12), the establishment of a meaningful change in score is necessary. The purpose of this study is to determine the threshold of the FJS-12 for detecting the patient acceptable symptom state (PASS) following primary TKA.
We retrospectively reviewed all patients who underwent elective, primary TKA and answered both the FJS-12 and the Knee Injury Osteoarthritis Outcome Survey, Joint Replacement KOOS, JR surveys 1-year postoperatively. The questionnaires were administered via a web-based electronic application. KOOS, JR score was used as the anchor. The anchor for PASS calculation should relate pain, physical function, and patient satisfaction. Two statistical methods were employed: (1) the receiver operating characteristic (ROC) curve point; (2) 75 percentile of the cumulative percentage curve of patients who had the KOOS, JR score difference larger than the cut-off value.
This study included 457 patients. The mean 1-year FJS-12 score was 42.6 ± 27.8. The mean 1-year KOOS, JR score was 68.0 ± 17.2. A high positive correlation between FJS-12 and KOOS, JR was found (r = 0.72, P < .001) making the KOOS, JR a valid external anchor. The threshold score of the FJS-12 which maximized the sensitivity and specificity for detecting a PASS was 33.3 (AUC = 0.78, 95% CI [0.74, 0.83]). The cut-off value computed with the 75 percentile approach was 77.1 (95% CI [73.9, 81.5]).
The PASS threshold for the FJS-12 was 33.3 and 77.1 at 1-year follow-up after primary TKA using the receiver operating characteristic (ROC) curve and 75 percentile approaches, respectively. These values can be used to assess the successful achievement of a forgotten joint.
Retrospective Cohort Study.
为了更好地了解全膝关节置换术（TKA）的临床获益，并提高遗忘关节评分（FJS-12）的可解释性，有必要建立评分的有意义变化。本研究的目的是确定 FJS-12 在检测初次 TKA 后患者可接受的症状状态（PASS）方面的阈值。
我们回顾性分析了所有接受择期初次 TKA 并在术后 1 年回答 FJS-12 和膝关节损伤骨关节炎结果调查（KOOS）、关节置换 JR 调查的患者。问卷调查通过基于网络的电子应用程序进行。KOOS、JR 评分被用作锚定。PASS 计算的锚定应与疼痛、身体功能和患者满意度相关。使用了两种统计方法：（1）接收者操作特征（ROC）曲线点；（2）KOOS、JR 评分差值大于截止值的患者累积百分比曲线的 75 百分位数。
本研究共纳入 457 例患者。平均 1 年 FJS-12 评分为 42.6 ± 27.8。平均 1 年 KOOS、JR 评分为 68.0 ± 17.2。FJS-12 与 KOOS、JR 之间存在高度正相关（r=0.72，P<.001），表明 KOOS、JR 是有效的外部锚定。FJS-12 用于检测 PASS 的最大敏感性和特异性的阈值评分为 33.3（AUC=0.78，95%CI[0.74，0.83]）。75 百分位方法计算的截断值为 77.1（95%CI[73.9，81.5]）。
使用 ROC 曲线和 75 百分位方法，初次 TKA 后 1 年 FJS-12 的 PASS 阈值分别为 33.3 和 77.1。这些值可用于评估遗忘关节的成功实现。
III 级回顾性队列研究。
