Interconverting the Joint Awareness Score and the Forgotten Joint Score: A Crosswalk Analysis

Background: Patient awareness of their artificial joint is a crucial component of satisfaction after total joint arthroplasty. The Forgotten Joint Score (FJS) is widely employed to evaluate this phenomenon; however, English-speaking patients may struggle to distinguish the answer choices-"never," "almost never," "seldom," "sometimes," and "mostly." The 6-question Joint Awareness Score (JAS) demonstrates proof-of-concept as a streamlined alternative to the 12-question FJS in total hip and knee arthroplasty patients. We hypothesized that the JAS would show acceptable internal consistency, correlate strongly with the FJS, and yield a near-linear crosswalk. Methods: To facilitate cross-comparisons and data pooling between the 2 measures, we performed a crosswalk analysis between the JAS and the FJS. The study included patients undergoing primary total hip and knee arthroplasty who completed both the FJS and JAS at their preoperative, 6-week, 6-month, and 1-year postoperative visits. Results: A total of 684 patients participated in the study, including 424 knees and 260 hips. The internal consistency of the JAS, as measured by Cronbach's alpha, ranged from 0.76 to 0.89. The Pearson correlation coefficient between the JAS and FJS ranged from 0.75 to 0.88 across all time points. Crosswalk analyses demonstrated a near-linear relationship between the FJS and JAS with Spearman correlation coefficients ranging from 0.88 to 0.90. Conclusions: Our results demonstrate a nearly direct conversion between the FJS and the JAS. The JAS is a shorter and more user-friendly alternative to the FJS for American English-speaking patients.