Singh Vivek, Bieganowski Thomas, Huang Shengnan, Karia Raj, Davidovitch Roy I, Schwarzkopf Ran
Department of Orthopedic Surgery, NYU Langone Health, New York, New York, USA.
Bone Jt Open. 2022 Apr;3(4):307-313. doi: 10.1302/2633-1462.34.BJO-2022-0010.R1.
The Forgotten Joint Score-12 (FJS-12) is a validated patient-reported outcome measure (PROM) tool designed to assess artificial prosthesis awareness during daily activities following total hip arthroplasty (THA). The patient-acceptable symptom state (PASS) is the minimum cut-off value that corresponds to a patient's satisfactory state-of-health. Despite the validity and reliability of the FJS-12 having been previously demonstrated, the PASS has yet to be clearly defined. This study aims to define the PASS of the FJS-12 following primary THA.
We retrospectively reviewed all patients who underwent primary elective THA from 2019 to 2020, and answered both the FJS-12 and the Hip Disability and Osteoarthritis Outcome Score, Joint Replacement (HOOS, JR) questionnaires one-year postoperatively. HOOS, JR score was used as the anchor to estimate the PASS of FJS-12. Two statistical methods were employed: the receiver operating characteristic (ROC) curve point, which maximized the Youden index; and 75th percentile of the cumulative percentage curve of patients who had the HOOS, JR score difference larger than the cut-off value.
This study included 780 patients. The mean one-year FJS-12 score was 65.42 (SD 28.59). The mean one-year HOOS, JR score was 82.70 (SD 16.57). A high positive correlation between FJS-12 and HOOS, JR was found (r = 0.74; p<0.001), making the HOOS, JR a valid external anchor. The threshold score of the FJS-12 that maximized the sensitivity and specificity for detecting a PASS was 66.68 (area under the curve = 0.8). The cut-off score value computed with the 75th percentile approach was 92.20.
The PASS threshold for the FJS-12 at one year following primary THA was 66.68 and 92.20 using the ROC curve and 75th percentile approaches, respectively. These values can be used to achieve consensus about meaningful postoperative improvement to maximize the utility of the FJS-12 to evaluate and counsel patients undergoing THA. Cite this article: 2022;3(4):307-313.
遗忘关节评分-12（FJS-12）是一种经过验证的患者报告结局测量（PROM）工具，旨在评估全髋关节置换术（THA）后日常活动期间的人工假体感知情况。患者可接受症状状态（PASS）是对应于患者健康满意状态的最小临界值。尽管FJS-12的有效性和可靠性先前已得到证实，但PASS尚未明确界定。本研究旨在确定初次THA后FJS-12的PASS。
我们回顾性分析了2019年至2020年接受初次择期THA的所有患者，并在术后一年回答了FJS-12和髋关节残疾与骨关节炎结局评分、关节置换（HOOS，JR）问卷。HOOS，JR评分用作锚定指标来估计FJS-12的PASS。采用了两种统计方法：使约登指数最大化的受试者工作特征（ROC）曲线点；以及HOOS，JR评分差异大于临界值的患者累积百分比曲线的第75百分位数。
本研究纳入780例患者。术后一年FJS-12的平均评分为65.42（标准差28.59）。术后一年HOOS，JR的平均评分为82.70（标准差16.57）。发现FJS-12与HOOS，JR之间存在高度正相关（r = 0.74；p<0.001），这使得HOOS，JR成为有效的外部锚定指标。使检测PASS的敏感性和特异性最大化时FJS-12的阈值评分为66.68（曲线下面积 = 0.8）。采用第75百分位数法计算的临界评分为92.20。
初次THA后一年，使用ROC曲线法和第75百分位数法时FJS-12的PASS阈值分别为66.68和92.20。这些值可用于就有意义的术后改善达成共识，以最大限度地利用FJS-12来评估和咨询接受THA的患者。引用本文：2022；3(4):307-313。
