15-year validation of the forgotten joint score after unicompartmental knee arthroplasty: A reliable indicator of long-term patient satisfaction and joint awareness

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-07-03 DOI:10.1016/j.jor.2025.06.018

R. Radhakrishnan, S. Xu, A.X. Han, X. Liu, M.H. Liow, H.N. Pang, D.K.J. Tay, S.J. Yeo, J.Y. Chen

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引用次数: 0

Abstract

Background

Unicompartmental knee arthroplasty (UKA) offers bone- and ligament-preserving treatment for medial compartment osteoarthritis. The Forgotten Joint Score (FJS) is a modern patient-reported outcome measure (PROM) that assesses joint awareness during daily activity—an ideal benchmark for long-term implant success. However, its utility beyond 10 years postoperatively remains insufficiently studied.

Purpose

To evaluate long-term clinical outcomes and validate the Forgotten Joint Score (FJS) 15 years following medial fixed-bearing UKA.

Methods

This retrospective cohort study included 54 patients who underwent medial UKA between 2003 and 2007 at a tertiary academic institution. Functional outcomes (Knee Society Knee Score [KSKS], Knee Society Function Score [KSFS], Oxford Knee Score [OKS], and SF-12 Physical and Mental Component Scores [PCS, MCS]) were assessed preoperatively and at 2, 10, and 15 years postoperatively. At 15 years, patients completed the FJS questionnaire unaided. Internal consistency (Cronbach's α), ceiling effects, Pearson correlations, and logistic regression were performed to assess construct validity and patient-perceived outcomes. Multiple linear regression identified preoperative predictors of FJS.

Results

Significant and sustained improvements were observed in KSFS, KSKS, OKS, and PCS up to 15 years postoperatively (p < 0.05). The mean FJS at 15 years was 78.6 (SD 23.1); 94.4 % of patients exceeded the PASS threshold, and 50 % achieved “forgotten joint” status (FJS ≥84.38). Internal consistency was excellent (Cronbach's α = 0.88). FJS showed strong correlations with OKS (r = 0.675, p < 0.001), KSFS (r = 0.470), and PCS (r = 0.340). Logistic regression confirmed FJS as a strong predictor of patient satisfaction (classification accuracy 90.7–92.6 %, p < 0.01). Preoperative KSFS was the only significant predictor of long-term FJS (β = 0.6, p = 0.029).

Conclusion

The Forgotten Joint Score is a reliable, internally consistent, and valid long-term outcome measure following medial UKA. Its strong associations with functional scores, patient satisfaction, and preoperative function support its incorporation into long-term clinical outcome assessment and highlight UKA's durability and patient acceptability at 15 years.

Level of evidence

III, Retrospective Cohort Study.

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单室膝关节置换术后遗忘关节评分的15年验证：长期患者满意度和关节意识的可靠指标

背景：腔室膝关节置换术（UKA）为内侧腔室骨关节炎提供了保留骨和韧带的治疗方法。遗忘关节评分（FJS）是一种现代患者报告的结果测量（PROM），用于评估日常活动中的关节意识，是长期植入成功的理想基准。然而，其在术后10年以上的应用仍未得到充分研究。目的评估内侧固定承重UKA后15年的长期临床结果并验证遗忘关节评分（FJS）。方法回顾性队列研究包括54例2003年至2007年间在某高等教育机构接受医学UKA的患者。术前、术后2年、10年和15年评估功能结局（膝关节社会评分[KSKS]、膝关节社会功能评分[KSFS]、牛津膝关节评分[OKS]和SF-12生理和心理成分评分[PCS， MCS]）。15年时，患者在没有帮助的情况下完成FJS问卷。采用内部一致性（Cronbach’s α）、天花板效应、Pearson相关性和逻辑回归来评估结构效度和患者感知结果。多元线性回归确定术前FJS的预测因素。结果术后15年，KSFS、KSKS、OKS和PCS均有显著且持续的改善(p <；0.05)。15岁时平均FJS为78.6 (SD 23.1)；94.4%的患者超过PASS阈值，50%的患者达到“遗忘关节”状态（FJS≥84.38）。内部一致性极好（Cronbach’s α = 0.88）。FJS与OKS有很强的相关性(r = 0.675, p <；0.001)、KSFS （r = 0.470）和PCS （r = 0.340）。Logistic回归证实FJS是患者满意度的强预测因子(分类准确率90.7 - 92.6%,p <；0.01)。术前KSFS是长期FJS的唯一显著预测因子（β = 0.6, p = 0.029）。结论遗忘关节评分是一种可靠的、内部一致的、有效的治疗内侧UKA的长期预后指标。它与功能评分、患者满意度和术前功能的强相关性支持其纳入长期临床结果评估，并突出了15年的UKA的耐久性和患者可接受性。证据水平ii，回顾性队列研究。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.