Patient Acceptable Symptom State for the Forgotten Joint Score in Primary Total Knee Arthroplasty

Singh, Vivek; Fiedler, Benjamin; Huang, Shengnan; Oh, Cheongeun; Karia, Raj; Schwarzkopf, Ran

doi:10.1016/j.arth.2022.03.069

Cited by 12 publications

(8 citation statements)

References 32 publications

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“…Joint awareness is a relatively novel dimension of patient‐reported outcomes, which refers the ability to forget joint arthroplasty during daily living activities 23 . Joint awareness can be assessed using the FJS‐12 scale 32,33 . The FJS‐12 has been translated into many languages and has shown good validity and reliability 34 .…”

Section: Discussionmentioning

confidence: 99%

The Negative Impacts of Sarcopenia on Primary Total Knee Arthroplasty under the Enhanced Recovery after Surgery Protocol

Zhou,

Li,

et al. 2024

Orthopaedic Surgery

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ObjectiveSarcopenia, as an emerging public health concern, has been associated with postoperative adverse outcomes in various surgical procedures. However, the evidence regarding the impacts of sarcopenia on total knee arthroplasty (TKA) remained limited. This study aimed to assess the impacts of sarcopenia on primary TKA based on the enhanced recovery after surgery (ERAS) protocol.MethodsThis retrospective study included 291 patients who received unilateral TKA from October 2017 to May 2018 in our institution. Sarcopenia was diagnosed based on the algorithm of Asian Working Group for Sarcopenia 2019. The handgrip strength was measured using a handheld dynamometer and the muscle mass was estimated by a previously validated anthropometric equation. Patients were classified into sarcopenia group and non‐sarcopenia group. The outcomes included complications, postoperative length of stay (LOS), total hospitalization cost, operative time, total estimated blood loss, blood transfusion rate, and the 12‐item forgotten joint score (FJS‐12) at the follow‐up. The propensity score matching (PSM) was used to adjust confounding factors. We compared continuous variables using Student's t‐test and the Wilcoxon Mann–Whitney U test for normal and non‐normal distributions, respectively, and categorical variables with chi‐square tests.ResultsOf the 291 patients, 58 (19.9%) patients were identified as having sarcopenia. After PSM, each group matched 42 patients. All matched patients were followed‐up at least 5 years. Patients with sarcopenia had higher rates of surgical complications compared to the non‐sarcopenia group (p = 0.019), and no significant difference was observed in 30‐day readmission, and periprosthetic joint infection. The sarcopenia group had significantly longer LOS (p = 0.038), higher total hospitalization (p = 0.015) than the non‐sarcopenia group. For the FJS‐12 scores at follow‐up, patients with sarcopenia had significantly higher scores than the non‐sarcopenia group (p = 0.024).ConclusionOur findings indicated sarcopenia may be a risk factor for postoperative complications, prolonged LOS, increased hospitalization cost and reduced patient satisfaction.

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Section: Discussionmentioning

confidence: 99%

The Negative Impacts of Sarcopenia on Primary Total Knee Arthroplasty under the Enhanced Recovery after Surgery Protocol

Zhou,

Li,

et al. 2024

Orthopaedic Surgery

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“…Another study determined the threshold of the FJS-12 for detecting the patient acceptable symptom state (PASS) following primary TKA [ 23 ]. They reported that 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 (confidence interval) [0.74, 0.83]).…”

Section: Discussionmentioning

confidence: 99%

Clinical and Radiographic Outcomes of Inversed Restricted Kinematic Alignment Total Knee Arthroplasty by Asia Specific (Huang’s) Phenotypes, a Prospective Pilot Study

Hsieh

Lin

Hung

et al. 2023

JCM

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Inverse restricted kinematic alignment (irKA) was modified from restricted kinematic alignment for total knee arthroplasty (TKA). This prospective single-center study aimed to evaluate the outcomes of irKA-TKA on all knee subtypes classified by Asia specific (Huang’s) phenotypes. A total of 96 knees that underwent irKA-TKA at one hospital between January 2018 and June 2020 were included, with 15 knees classified in Type 1, nine in Type 2, 15 in Type 3, 47 in Type 4, and 10 in Type 5 by Huang’s phenotypes. Outcomes were knee alignment measures and patient-reported satisfaction evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and traditional Chinese version of the Forgotten Joint Score-12 (FJS-12). Follow-up was one year. Type 4 knee was most significantly corrected in all angles by irKA-TKA, followed by Type 2 and 3 knees. Type 5 and 1 knee were only significantly corrected in some angles. The correlation between FJS-12 and WOMAC was good at 6 months (Pearson correlation coefficient (r) = 0.74) and moderate at 6 weeks, 3 months, and 12 months during follow-up (r = 0.37~0.47). FJS-12 and WOMAC displayed comparable hip–knee–ankle angle cut-off value (4.71° vs. 6.20°), sensitivity (70.49% vs. 67.19%), specificity (84.00% vs. 85.71%), and Youden index (54.49% vs. 52.90%) in prediction of good prognosis. In conclusion, irKA-TKA corrects knee alignment in all knee types with increasing satisfaction for one-year follow-up. Knees with presurgical varus deformity are most recommended for irKA-TKA. Both presurgical scores of the traditional Chinese version of FJS-12 and WOMAC predict the prognosis of irKA-TKA.

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“…Third, we did not use a clinical established patient reported outcome measure (PROM) to evaluate clinical satisfaction, which makes comparison of our clinical results to these of other authors difficult. Although PROMs may be valuable in comparison of various surgical treatments and differences between distinct population groups, clinical interpretation of these differences can sometimes be misleading [14]. Meaning, a statistically significant change with a p value < 0.05 in scores may not necessarily translate into a considerable change for patients clinically [17].…”

Section: Discussionmentioning

confidence: 99%

“…Satisfied patients were specifically asked: "Are there any restrictions or complaints in the area of the operated hallux at all?" If this question was answered in the affirmative (there are no restrictions/complaints at all), then this was classified as "forgotten bunion" (in accordance to a perfect result after joint arthroplasty [14]). Radiographically, images were taken in a standardized fashion (foot dorso-plantar and lateral under full weight bearing) and the following measures were taken: degree of displacement of the first MTH in percent to the shaft diameter (< 70%, 70-90%, > 90%), HVA and IMA.…”

Section: Methodsmentioning

confidence: 99%

The distal metatarsal screw is not always necessary in third-generation MICA: a case–control study

Harrasser

Hinterwimmer

Baumbach³

et al. 2022

Arch Orthop Trauma Surg

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Introduction To evaluate the clinical and radiological results after fixation of the first metatarsal head (MTH) with one or two screws as part of the third-generation minimally invasive Chevron–Akin osteotomy (MICA) for hallux valgus deformities. Materials and methods Between August 2020 and November 2021, 55 MICA procedures (50 patients, male:female = 7:43), 22 with two (MICA2), 33 with one screw (MICA1) were performed for mild to severe hallux valgus deformities. Exclusion criteria were a concomitant pes adductus (Sgarlato angle > 20°) or hindfoot/midfoot deformities requiring treatment. In 27 cases, additional procedures on the forefoot (small toe corrections or metatarsal osteotomies II–V) were necessary. Pre- and post-operatively, hallux valgus angle (HVA) and intermetatarsal I/II angle (IMA) were measured. Clinically, subjective satisfaction, range of motion (ROM) of the first metatarsophalangeal joint (MTPJ), and pain level (NRS score) were evaluated. The minimum follow-up was 12 months. Results Displacement of MTH was 70–90% on average, all osteotomies showed full consolidation at latest follow-up. In one case of either group, a slight subsidence of MTH was documented. The radiological and clinical parameters showed no differences between the groups. The pain level improved by an average of three points. The mobility of the MTPJ showed a slight reduction in nine cases after three months (4 MICA2, 5 MICA1) which persisted in three cases. Fifty-two of 55 patients (95%) would opt again for the operation. Conclusions Fixation of the first MTH with a single bicortical screw in MICA with moderate lateralization of MTH shows stable anchoring and good clinical results. The routine use of a second metatarsal screw can be omitted.

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Patient Acceptable Symptom State for the Forgotten Joint Score in Primary Total Knee Arthroplasty

Cited by 12 publications

References 32 publications

The Negative Impacts of Sarcopenia on Primary Total Knee Arthroplasty under the Enhanced Recovery after Surgery Protocol

The Negative Impacts of Sarcopenia on Primary Total Knee Arthroplasty under the Enhanced Recovery after Surgery Protocol

Clinical and Radiographic Outcomes of Inversed Restricted Kinematic Alignment Total Knee Arthroplasty by Asia Specific (Huang’s) Phenotypes, a Prospective Pilot Study

The distal metatarsal screw is not always necessary in third-generation MICA: a case–control study

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