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Arin-Bal G, Kinikli GI, Bozgeyik S, Tan F, Turhan E, Guney-Deniz H. Translation and Cross-Cultural Adaptation of the Anterior Cruciate Ligament Donor Site Morbidity Questionnaire Into Turkish. Eval Health Prof 2024; 47:126-132. [PMID: 37671783 DOI: 10.1177/01632787231195073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
This study aimed to translate the ACL Donor Site Morbidity (ACL-DSM) questionnaire into Turkish and assess the reliability and validity of the Turkish version of the ACL-DSM questionnaire (ACL-DSM-Tr) among individuals following anterior cruciate ligament (ACL) reconstruction. The process involved forward and back-translation, cultural adaptation, and validation of the ACL-DSM-Tr questionnaire on ninety-nine patients (mean age 30.73 ± 8.55 years). Participants completed ACL-DSM-Tr, International Knee Documentary Committee (IKDC) subjective form, ACL Return to Sport (ACL-RSI), and Forgotten Joint Scale (FJS) questionnaires. The internal consistency, reliability, and validity of the ACL-DSM-Tr were analyzed. The ACL-DSM-Tr demonstrated a high internal consistency (Cronbach's alpha .755) and excellent test-retest reliability (Spearman correlation r = .811, p < .001; Cronbach's alpha .890). The ACL-DSM-Tr score exhibited a strong positive correlation with the IKDC score (r = .690, p < .001) and a moderate positive correlation with the FJS score (r = .535, p < .001). Despite a fair correlation between ACL-DSM-Tr and ACL- RSI subgroup scores, no significant correlation was observed with the ACL-RSI total score (p = .297). In conclusion, the ACL-DSM-Tr demonstrated internal consistency, reliability, and validity in patients with ACL reconstruction. This questionnaire has the potential to yield significant benefits in monitoring patient satisfaction and evaluating the level of comfort experienced at the donor site following ACL reconstruction.
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Affiliation(s)
- Gamze Arin-Bal
- Department of Musculoskeletal Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Gizem Irem Kinikli
- Department of Musculoskeletal Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Sibel Bozgeyik
- Department of Musculoskeletal Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Firat Tan
- Department of Musculoskeletal Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Egemen Turhan
- Department of Orthopedics and Traumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Hande Guney-Deniz
- Department of Musculoskeletal Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Kuhns BD, Harris WT, Domb BG. Low Ceiling Effects of the Forgotten Joint Score Compared With Legacy Measures After Joint-Preserving Procedures: A Systematic Review. Arthroscopy 2023; 39:2086-2095. [PMID: 36804458 DOI: 10.1016/j.arthro.2023.01.107] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 01/17/2023] [Accepted: 01/31/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE To determine, in patients undergoing joint preservation procedures, whether the Forgotten Joint Score (FJS) compares favorably with legacy measures. METHODS Medical databases (including PubMed/MEDLINE and Embase databases) were queried for publications with the terms "Forgotten Joint Score" and "hip," "knee," "arthroscopy," or "ACL." Fourteen studies met the inclusion criteria. Methodologic quality was assessed through the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist, and psychometric data were evaluated for ceiling or floor effects, convergent validity, internal consistency, reliability, responsiveness, measurement invariance, and measurement error by 2 fellowship-trained orthopaedic surgeons (B.D.K. and W.T.H.). RESULTS Data were collected from 14 studies using the FJS after joint-preserving procedures in 911 patients (959 joints). Four studies reported strong internal consistency with an average Cronbach α of 0.92. Two studies reported responsiveness with an effect size ranging from 0.6 to 1.16. One study reported reproducibility with an interclass correlation coefficient of 0.9 (95% confidence interval, 0.8-0.9). One study reported measurement error with an minimum detectable change (MDC)individual of 32% and MDCgroup of 4.5%. Studies reported moderate to very strong convergent validity across legacy measures for hip and knee preservation surgery. Ceiling effects were favorable compared with many legacy scores for hip and knee preservation. Three studies reported the minimal clinically important difference whereas 1 study reported the patient acceptable symptomatic state for the FJS. CONCLUSIONS The FJS is a methodologically sound outcome measure used to evaluate patient outcomes after hip and knee preservation surgery with overall low ceiling effects compared with legacy measures. LEVEL OF EVIDENCE Level IV, systematic review of Level III and IV studies.
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Affiliation(s)
- Benjamin D Kuhns
- American Hip Institute Research Foundation, Chicago, Illinois, U.S.A..
| | - W Taylor Harris
- American Hip Institute Research Foundation, Chicago, Illinois, U.S.A
| | - Benjamin G Domb
- American Hip Institute Research Foundation, Chicago, Illinois, U.S.A
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Sava MP, Schelker BL, Khan ZA, Amsler F, Hirschmann MT. Use of the forgotten joint score (FJS)-12 to evaluate knee awareness after quadriceps tendon reconstruction. BMC Musculoskelet Disord 2023; 24:431. [PMID: 37254174 DOI: 10.1186/s12891-023-06574-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/26/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Quadriceps tendon rupture (QTR) is a severe injury of the knee extensor apparatus. The study aims to validate the use of forgotten joint score (FJS-12) for functional outcome assessing after surgical treatment of QTR. METHODS Fifty-seven patients who underwent surgery for QTR with transosseous suture reconstruction in a single orthopaedic surgery and traumatology center between 2015 and 2020 were eligible for enrolment in this retrospective case series. The demographic data and other pre-operative details such as age, gender, comorbidities and medication use also were extracted from the medical records. Patient reported outcome measures (PROMs) were gathered in the form of Western Ontario and McMaster Universities Arthritis Index Score (WOMAC), Tegner Activity Score (TAS), Lysholm Score and FJS-12 at a mean follow-up time of 49.84 months ± 20.64 months. The FJS-12 was validated by correlation with WOMAC, TAS and Lysholm Score. RESULTS The mean age of all patients were 69.2 ± 13.6 years with 51 (89.5%) males and 6 (10.5%) females. The mean time from injury to surgery was 3.39 ± 5.46 days. All patients reported satisfactory functional outcomes after surgery on FJS-12, WOMAC and Lysholm scores, except the TAS, which decreased slightly from pre-operative level. There was a high negative correlation between WOMAC and FJS-12, but moderate positive correlations between FJS-12 and TAS and Lysholm scores. The Cronbach's alpha value was 0.96 for 12 items in FJS-12. CONCLUSION This study has found that FJS-12 is a reliable and easy to assess tool for functional outcomes after QTR reconstruction. It has shown moderate to strong correlation with other commonly used outcome measures (WOMAC, TAS and Lysholm).
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Affiliation(s)
- Manuel P Sava
- Department of Orthopedic Surgery and Traumatology, Kantonsspital Baselland, CH-4101, Bruderholz, Switzerland
- Department of Clinical Research, Research Group Michael T. Hirschmann, Regenerative Medicine & Biomechanics, University of Basel, CH-4001, Basel, Switzerland
| | - Benjamin L Schelker
- Department of Orthopedic Surgery and Traumatology, Kantonsspital Baselland, CH-4101, Bruderholz, Switzerland
- Department of Clinical Research, Research Group Michael T. Hirschmann, Regenerative Medicine & Biomechanics, University of Basel, CH-4001, Basel, Switzerland
| | - Zainab A Khan
- Department of Orthopedic Surgery and Traumatology, Kantonsspital Baselland, CH-4101, Bruderholz, Switzerland
- Department of Clinical Research, Research Group Michael T. Hirschmann, Regenerative Medicine & Biomechanics, University of Basel, CH-4001, Basel, Switzerland
- Research and Development Department, AO Hospital, Karachi, Pakistan
| | - Felix Amsler
- Amsler Consulting, Gundeldingerrain 111, CH-4059, Basel, Switzerland
| | - Michael T Hirschmann
- Department of Orthopedic Surgery and Traumatology, Kantonsspital Baselland, CH-4101, Bruderholz, Switzerland.
- Department of Clinical Research, Research Group Michael T. Hirschmann, Regenerative Medicine & Biomechanics, University of Basel, CH-4001, Basel, Switzerland.
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Das L, Johri AS, Abdusamad V, Schuh A, Goyal T. Joint awareness and return to pre-injury level of activities after ACL reconstruction in athletes vs non-athletes. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2022; 33:819-827. [PMID: 35119487 DOI: 10.1007/s00590-022-03208-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/05/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE The outcome of arthroscopic anterior cruciate ligament reconstruction (ACLR) in the non-athlete population is under-reported. The study aimed to compare the functional outcomes of ACLR in the non-athlete and athlete population by patient reported outcome measures (PROMs)- International Knee Documentation Committee score (IKDC), Lysholm knee scoring scale, Forgotten joint score (FJS-12) and return to pre-injury activity level. The study also correlated the FJS-12 score with other commonly used PROM's (IKDC and Lysholm). METHODS This was a prospective comparative study including patients undergoing ACLR. Patients were divided into two groups. Group-1 (non-athletes) and Group-2 (athletes, defined as those with pre-injury Tegner activity level > 5). Demographic profile, management of associated meniscal injury, perioperative and midterm complications were noted. All patients had 24 months follow-up. Knee laxity assessment by pivot shift test, functional outcome scores (Lysholm and IKDC) and FJS-12 were assessed preoperatively and postoperatively at 12 and 24 months. RESULTS Group 1 and 2 included 69 and 47 participants, respectively, (total 116 patients). The mean age of group 1 was significantly higher than group 2 (33.1 ± 8.0 vs 25.0 ± 4.9 years; p < 0.005). There was no statistically significant difference in PROMs and FJS-12 scores between the groups at any follow-up. Return to pre-injury Tegner activity level post-ACLR was 88.4% (n = 61) and 46.8% (n = 22) in group 1 and 2, respectively (p). The ceiling effect in FJS-12, IKDC, and Lysholm scores were achieved by 9.3%, 19.5%, and 34.7% of patients (n = 116), respectively, at 2-year follow-up. The ceiling effect of FJS-12, Lysholm, and IKDC scores between the groups at final follow-up was not statistically significant (p = 1, p = .524, p = .09, respectively). CONCLUSION The functional outcome of ACLR was comparable between athletes and non-athletes. FJS-12 has a lower ceiling effect and better discriminatory power than Lysholm and IKDC scores. FJS-12 score can be satisfactorily used in ACLR to observe and monitor changes in patient satisfaction and outcome. LEVEL OF STUDY II, Prospective comparative study.
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Affiliation(s)
- Lakshmana Das
- Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India
| | - Anant Shiv Johri
- University Hospitals of Morecambe Bay NHS Trust-Royal Lancaster Infirmary, Ashton Road, Lancaster, LA1 4RP, UK
| | - V Abdusamad
- Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India
| | - Alexander Schuh
- Department of Musculoskeletal Research, Hospital of Trauma Surgery, Marktredwitz Hospital, Marktredwitz, Germany
| | - Tarun Goyal
- Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India.
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Lee JY, Yeo WW, Chia ZY, Chang P. Normative FJS-12 scores for the knee in an Asian population: a cross-sectional study. Knee Surg Relat Res 2021; 33:40. [PMID: 34717774 PMCID: PMC8557544 DOI: 10.1186/s43019-021-00122-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/19/2021] [Indexed: 11/28/2022] Open
Abstract
Background The Forgotten Joint Score is a patient-reported outcome measure validated in assessing patients post knee arthroplasty, anterior cruciate ligament (ACL) reconstruction surgery and patellar dislocation. A previous study had established the normative scores of a population in the USA but included knees with pathology. The aim of our study is to obtain normative Forgotten Joint Scores in young Asian adults without any pre-existing knee pathologies to increase the interpretability of the Forgotten Joint Score-12 (FJS-12) score. Methods We conducted a cross-sectional study across young healthy Asian adults via electronic platforms. Participants who had sought either Western medical consultation, physiotherapy or traditional medical therapies were excluded. Demographic data, occupation, type of sport played, and FJS-12 scores were collected. Scores were stratified into subgroups and analysed. Results There were 172 participants who met our inclusion criteria for this study. The average age of participants in our study was 28.1 ± 10.5 years (range 14–70 years), with 83 (47.7%) participants falling into the ages 21–25 years. Average body mass index (BMI) was 21.9 ± 3.3 kg/m2 (range 14.7–36.3 kg/m2). The average FJS-12 score was 62.8 ± 25.6. The median FJS-12 was 63.5 with a range of 4.2–100. Nine participants (5.2%) scored the maximum score possible, and 56 (32.6%) participants scored below the midpoint score of 50. The percentiles for each subgroup of participants were tabulated and reported. Notably, males aged 46–70 years old scored the highest average FJS-12 score of 73.4 ± 5.5, and females aged 31–45 years old scored the lowest FJS-12 score of 57.1 ± 25.1. Females scored lower than males, although the difference was not statistically significant (p = 0.157). There were no significant correlations between BMI, age, or type of sport played with FJS-12; however, interestingly, we observed that women reported similar FJS-12 scores across all age groups, while men reported better scores with increasing age.Interestingly,
we observed that women reported similar FJS-12 scores across all age groups,
while men reported better scores with increasing age. Conclusion Having normative values provides opportunities for benchmarking and comparing individuals against age- and gender-matched peers in the general population. Knowledge of normative values for FJS-12 scores would aid evaluating and tracking progress in patients recovering from injuries or undergoing post-surgery rehabilitation. This would help clinicians determine if they return to ‘normal’ post intervention. Supplementary Information The online version contains supplementary material available at 10.1186/s43019-021-00122-2.
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Affiliation(s)
- Jia Ying Lee
- Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia Level 4, Singapore, 169856, Singapore.
| | - Wai Weng Yeo
- University of New South Wales, Sydney, Australia
| | - Zi Yang Chia
- Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia Level 4, Singapore, 169856, Singapore
| | - Paul Chang
- Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia Level 4, Singapore, 169856, Singapore
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Vermeijden HD, Yang XA, van der List JP, DiFelice GS. Reliable Internal Consistency and Adequate Validity of the Forgotten Joint Score-12 after Primary Anterior Cruciate Ligament Repair. Arthrosc Sports Med Rehabil 2021; 3:e893-e900. [PMID: 34195659 PMCID: PMC8220601 DOI: 10.1016/j.asmr.2021.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/05/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose To validate the Forgotten Joint Score-12 (FJS-12) as a subjective outcome metric for patients undergoing arthroscopic primary anterior cruciate ligament (ACL) repair. Methods In this retrospective study, all patients undergoing primary ACL repair for complete isolated proximal tears between 2008 and 2018 were eligible for inclusion. Patients were contacted and asked to complete the FJS-12, Lysholm Knee Score, modified Cincinnati score, Single Assessment Numeric Evaluation (SANE), Subjective International Knee Documentation Committee (IKDC), and Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) scale at a minimum of 1 year of follow-up. Internal consistency, convergent validity, and ceiling effects were analyzed. Results Ninety-six patients could be included (62%), with a mean FJS-12 score of 86.9 ± 14.0 (range, 31.3-100). The FJS-12 showed reliable internal consistency (Cronbach’s alpha = 0.89). Construct validity was moderate to strong (r = 0. 621-0.702). Ceiling effect for the FJS-12 was 21.9%, which was lower than for the Lysholm (44.6%), modified Cincinnati (45.1%), equal to the IKDC subjective (21.9%), and SANE score (22.0%) but higher compared to the ACL-RSI (12.8%). Furthermore, internal consistency for the other scores was also good to excellent (range Cronbach’s alpha = 0.627-0.953). Conclusion The FJS-12 shows high internal consistency and construct validity after primary ACL repair. Furthermore, this metric showed equal or less ceiling effect than most other scores, although still notable. This study suggests that the FJS-12 is an easy and validated outcome metric to evaluate subjective primary repair outcomes. Level of Evidence Level III, diagnostic study.
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Affiliation(s)
- Harmen D. Vermeijden
- Hospital for Special Surgery, Department of Orthopaedic Surgery, New York, NY, U.S.A
- Spaarne Gasthuis Hospital, Department of Orthopaedic Surgery, Hoofddorp
- Amsterdam UMC, University of Amsterdam, Amsterdam Movement Science, Department of Orthopaedic Surgery, Amsterdam, The Netherlands
| | - Xiuyi A. Yang
- Hospital for Special Surgery, Department of Orthopaedic Surgery, New York, NY, U.S.A
| | - Jelle P. van der List
- Hospital for Special Surgery, Department of Orthopaedic Surgery, New York, NY, U.S.A
- Spaarne Gasthuis Hospital, Department of Orthopaedic Surgery, Hoofddorp
- Amsterdam UMC, University of Amsterdam, Amsterdam Movement Science, Department of Orthopaedic Surgery, Amsterdam, The Netherlands
| | - Gregory S. DiFelice
- Hospital for Special Surgery, Department of Orthopaedic Surgery, New York, NY, U.S.A
- Address correspondence to Gregory S. DiFelice, M.D., Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021, U.S.A.
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