The Forgotten Joint and Forgotten Spine: Recalibrating Success around the Patient's Experience

Introduction: Patient-reported outcome measures have moved to the center of orthopedic and spine research, yet many legacy instruments-the VAS, ODI, KOOS, and generic health-utility tools-suffer from ceiling effects that blunt their ability to discriminate excellent outcomes from merely good ones. The concept of the "forgotten joint" reframes success around the patient's ability to forget that a joint was ever replaced, and the Forgotten Joint Score (FJS) operationalises this idea with demonstrated responsiveness, low ceiling effects, and strong measurement properties across arthroplasty and joint-preserving procedures. This paradigm is now being carried into the axial skeleton through the Forgotten Spine Score (FSS) and a cervical adaptation (FS3-C), which quantify spine awareness rather than residual disability. This editorial examines the evidence underpinning the FJS, the early validation of its spinal analog-ues, their clinical and health-system relevance in an era of value-based care, and the caveats-cultural adaptation, digital exclusion, and an embryonic spinal evidence base-that must temper their adoption. The most successful operation, ultimately, is the one the patient is free t-----o forget.