The Forgotten Joint Score Is a Valid Outcome Measure for Total Ankle Arthroplasty: A Prospective Study.

IF 4.2 2区 医学 Q1 ORTHOPEDICS Clinical Orthopaedics and Related Research® Pub Date : 2024-10-01 Epub Date: 2024-04-26 DOI:10.1097/CORR.0000000000003083
Antonio Mazzotti, Simone Ottavio Zielli, Elena Artioli, Michele Astolfi, Laura Langone, Cesare Faldini
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Abstract

Background: The success of total ankle arthroplasty (TAA) involves objective and subjective parameters such as joint motion and implant survival. Patient-reported outcome measures provide key context from the patient's perspective so that we can evaluate the results of these procedures. The Forgotten Joint Score (FJS) has demonstrated validity and reliability in other arthroplasties, but the existing evidence on the FJS in TAA is very limited.

Question/purposes: We aimed to assess the reliability, validity, responsiveness to change, and floor and ceiling effects, as well as to perform a gender analysis, of the FJS in patients who had undergone TAA.

Methods: A prospective, observational study enrolled patients who underwent TAA at our institution between June 2021 and May 2023. The three-component TAA was performed through an anterior approach. A total of 120 patients (mean age 62 ± 10 years) participated, which was 83% (120 of 145) of those eligible, and 77% (92 of 120) of those patients underwent follow-up assessments at 12 ± 1 months after surgery. A cross-culturally adapted and validated version of the FJS in our language (Italian) was used. Additionally, three other commonly used patient-reported outcome measures for TAA were administered: the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, the Manchester-Oxford Foot Questionnaire (MOXFQ), and the VAS.

Results: Reliability was demonstrated by excellent internal consistency (Cronbach α coefficient = 0.95) and excellent test-retest reliability (intraclass correlation coefficient = 0.99; standard error of measurement = 2.7). Robust validity was observed, in that the FJS had a strong correlation with the AOFAS ankle-hindfoot score, the MOXFQ, and the VAS (Pearson and Spearman values consistently above 0.7 or below -0.7). Responsiveness to change was observed between 6 and 12 months (Cohen d = 0.37). Low ceiling and floor effects at both 6 months (4% and 3% reached top and bottom scores, respectively) and 12 months (10% and 0% reached top and bottom scores, respectively) were demonstrated, below the recommended 15% interpretability threshold. No association between outcomes and patient gender was observed.

Conclusion: Test properties and validity of the FJS were strong in patients who underwent TAA. It seems suitable for clinical use, although future studies should seek to replicate or refute our findings in other patient populations.

Level of evidence: Level II, therapeutic study.

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被遗忘的关节评分是衡量全踝关节置换术效果的有效方法:前瞻性研究
背景:全踝关节置换术(TAA)的成功与否涉及关节活动度和植入物存活率等主客观参数。患者报告的结果指标从患者的角度提供了关键的背景信息,以便我们评估这些手术的结果。被遗忘关节评分(FJS)已在其他关节置换术中证明了有效性和可靠性,但在 TAA 中使用 FJS 的现有证据非常有限:我们的目的是评估 FJS 在 TAA 患者中的可靠性、有效性、对变化的反应性、下限和上限效应,并进行性别分析:一项前瞻性观察研究招募了2021年6月至2023年5月期间在我院接受TAA手术的患者。三部分 TAA 均通过前路进行。共有120名患者(平均年龄62±10岁)参与了研究,占符合条件者的83%(145人中的120人),其中77%的患者(120人中的92人)在术后12±1个月接受了随访评估。该研究使用了经过跨文化改编和验证的意大利语版本的 FJS。此外,还采用了其他三种常用的患者报告 TAA 结果的方法:美国骨科足踝协会(AOFAS)踝关节-后足评分、曼彻斯特-牛津足部问卷(MOXFQ)和 VAS:结果:曼彻斯特-牛津足部问卷(MOXFQ)和VAS的可靠性表现为极好的内部一致性(克朗巴赫α系数=0.95)和极好的测试-再测试可靠性(类内相关系数=0.99;测量标准误差=2.7)。FJS 与 AOFAS 踝关节-后足评分、MOXFQ 和 VAS 有很强的相关性(皮尔逊值和斯皮尔曼值始终高于 0.7 或低于-0.7),因此具有很强的有效性。在 6 个月和 12 个月期间,观察到了对变化的反应性(Cohen d = 0.37)。6 个月(分别有 4% 和 3% 达到最高分和最低分)和 12 个月(分别有 10% 和 0% 达到最高分和最低分)的上限和下限效应较低,低于建议的 15% 可解释性阈值。结果与患者性别之间没有关联:结论:在接受 TAA 的患者中,FJS 具有很强的测试特性和有效性。尽管未来的研究应寻求在其他患者群体中复制或反驳我们的发现,但它似乎适合临床使用:二级,治疗性研究。
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来源期刊
CiteScore
7.00
自引率
11.90%
发文量
722
审稿时长
2.5 months
期刊介绍: Clinical Orthopaedics and Related Research® is a leading peer-reviewed journal devoted to the dissemination of new and important orthopaedic knowledge. CORR® brings readers the latest clinical and basic research, along with columns, commentaries, and interviews with authors.
期刊最新文献
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