Related Experiment Video
Updated: Oct 11, 2025
The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
Changes and thresholds in the Forgotten Joint Score after total hip arthroplasty : minimal clinically important
Patrick G Robinson1, Deborah J MacDonald1,2, Gavin J Macpherson1
1Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.
Aims:
The aim of this study was to identify the minimal clinically important difference (MCID), minimal important change (MIC), minimal detectable change (MDC), and patient-acceptable symptom state (PASS) in the Forgotten Joint Score (FJS) according to patient satisfaction six months following total hip arthroplasty (THA) in a UK population.
Methods:
During a one-year period, 461 patients underwent a primary THA and completed preoperative and six-month FJS, with a mean age of 67.2 years (22 to 93). At six months, patient satisfaction was recorded as very satisfied, satisfied, neutral, dissatisfied, or very dissatisfied. The difference between patients recording neutral (n = 31) and satisfied (n = 101) was used to define the MCID. MIC for a cohort was defined as the change in the FJS for those patients declaring their outcome as satisfied, whereas receiver operating characteristic curve analysis was used to determine the MIC for an individual and the PASS. Distribution-based methodology was used to calculate the MDC.
Results:
Using satisfaction as the anchor, the MCID for the FJS was 8.1 (95% confidence interval (CI) 3.7 to 15.9; p = 0.040), which was affirmed when adjusting for confounding. The MIC for the FJS for a cohort of patients was 17.7 (95% CI 13.7 to 21.7) and for an individual patient was 18. The MDC90 for the FJS was eight, meaning that 90% of patients scoring more than this will have experienced a real change that is beyond measurement error. The PASS threshold for the FJS was defined as 29.
Conclusion:
The MCID and MIC can be used respectively to assess whether there is a clinical difference between two groups, or whether a cohort or patient has had a meaningful change in their FJS. Both values were greater than measurement error (MDC90), suggesting a real change. The PASS threshold for the postoperative FJS can be used as a marker of achieving patient satisfaction following THA. Cite this article: Bone Joint J 2021;103-B(12):1759-1765.
Insights
This study determined important change scores for the Forgotten Joint Score (FJS) after total hip arthroplasty (THA). These scores help assess patient outcomes and satisfaction following hip replacement surgery.
Area of Science:
- Orthopedics
- Arthroplasty
- Patient-Reported Outcome Measures
Background:
- Total hip arthroplasty (THA) aims to improve patient function and satisfaction.
- Quantifying meaningful improvement after THA is crucial for clinical evaluation.
- The Forgotten Joint Score (FJS) is a patient-reported outcome measure used post-THA.
Purpose of the Study:
- To identify the minimal clinically important difference (MCID), minimal important change (MIC), minimal detectable change (MDC), and patient-acceptable symptom state (PASS) for the FJS.
- To correlate these FJS metrics with patient satisfaction six months after THA.
- To establish benchmarks for interpreting FJS scores in a UK population undergoing THA.
Main Methods:
- A cohort of 461 patients undergoing primary THA completed the FJS preoperatively and at six months.
- Patient satisfaction was assessed at six months using a Likert scale.
- Statistical methods including anchor-based (satisfaction) and distribution-based approaches were used to derive MCID, MIC, MDC, and PASS values.
Main Results:
- The MCID for the FJS was 8.1, indicating the smallest change perceived as important by patients.
- The MIC was 17.7 for a cohort and 18 for an individual patient, signifying a meaningful change.
- The MDC90 was 8, representing the threshold beyond measurement error, and the PASS threshold was 29.
Conclusions:
- The derived MCID and MIC values for the FJS are greater than the MDC90, confirming a real and meaningful change post-THA.
- The MCID and MIC can differentiate between groups and assess meaningful change in FJS scores.
- The PASS threshold of 29 serves as a benchmark for achieving patient satisfaction after THA.
More Related Videos
06:28Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
Published on: December 13, 2024
07:45The Use of Mixed Reality in Custom-Made Revision Hip Arthroplasty: A First Case Report
Published on: August 4, 2022