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Evaluation of joint awareness after acetabular fracture: Validation of the Forgotten Joint Score according to the COSMIN checklist protocol

Authors
  • Freigang, Viola
  • Weber, Johannes
  • Mueller, Karolina
  • Pfeifer, Christian
  • Worlicek, Michael
  • Alt, Volker
  • Baumann, Florian Michael
Type
Published Article
Journal
World Journal of Orthopedics
Publisher
Baishideng Publishing Group Co (World Journal of Orthopedics)
Publication Date
Feb 18, 2021
Volume
12
Issue
2
Pages
69–81
Identifiers
DOI: 10.5312/wjo.v12.i2.69
PMID: 33614426
PMCID: PMC7866484
Source
PubMed Central
Keywords
Disciplines
  • Clinical Trials Study
License
Green

Abstract

BACKGROUND A fracture of the acetabulum is an uncommon, but serious injury. Established outcome tools do not reflect the patient’s perspective after fracture of the hip joint. Originally designed for post-arthroplasty patients, the Forgotten Joint Score (FJS) is a patient-reported outcome measurement (PROM) tool evaluating the disease-specific health-related quality of life (HR-QoL). AIM To validate the FJS in patients after acetabular fracture. METHODS In a prospective mono-centric cohort study, we evaluated 100 patients at mean 5.2 ± 3.6 years after a fracture of the acetabulum. The validation study followed the complete COSMIN checklist protocol. For calculation of convergent validity, we used the Tegner-Activity Scale, the Western Ontario and McMaster Universities Osteoarthritis Index, the EuroQol-5D, and a subjective rating of change as an anchor variable. RESULTS We confirmed good internal consistency with a Cronbach‘s alpha of 0.95. With an intraclass correlation coefficient of 0.99 (95%CI: 0.97, 0.99), test-retest reliability of the FJS was excellent. Correlation coefficients between the questionnaires were moderate to high ranging from |0.56| to |0.83| (absolute value). No relevant floor or ceiling effects occurred. Standard error of measurement was 3.2 and smallest detectable change (SDC) was 8.8. Thus, changes greater than 8.8 points between two assessments denote a real change in FJS. CONCLUSION The FJS is a valid and reliable tool for evaluation of patient-reported outcome in posttraumatic condition after acetabular fracture. The SDC indicating a real clinical improvement was 8.8 points in the FJS. We could confirm responsiveness of the FJS and found no relevant floor- or ceiling effects.

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