About the Forgotten Joint Score
The Forgotten Joint Score (FJS) is a unique patient-reported outcome measure that evaluates how well you have adapted to your artificial joint. Unlike traditional questionnaires that focus on pain or functional limitations, the FJS asks about your awareness of your joint during everyday activities. The goal of joint replacement surgery is not just to reduce pain, but to restore your joint function so completely that you can "forget" about it during normal activities. A high FJS score means you rarely think about your artificial joint - a sign of a very successful outcome.
Medical Specialties
Anatomic Areas
Clinical Indications
Developer Information
The Forgotten Joint Score (FJS) was developed by Dr. Henning Behrend, Dr. Francesco Giesinger, and colleagues at the University of Zurich, Switzerland, and published in 2012. The FJS was created to address a gap in traditional patient-reported outcome measures by focusing on the unique concept of joint "forgetting" - the ability of patients to be unaware of their artificial joint during everyday activities. This novel approach captures the ultimate goal of joint replacement surgery: to restore function so completely that patients forget they have an artificial joint.
Copyright & Licensing
The Forgotten Joint Score is freely available for clinical and research use without licensing fees. The questionnaire can be used, reproduced, and distributed for non-commercial purposes without permission. Proper citation of the original development and validation studies (Behrend et al., 2012) is requested when using the FJS in research or publications. Translations into other languages should follow proper validation protocols.
Administration Instructions
Think about the past week and rate your awareness of your artificial joint during each activity. Use the scale from "Never" to "Mostly". If you did not perform an activity, estimate your awareness based on similar activities.
Scoring Methodology
The FJS uses a 5-point Likert scale (0-4) for each of the 12 questions: 0 = Never aware, 1 = Almost never, 2 = Seldom, 3 = Sometimes, 4 = Mostly aware. The total score is calculated using the formula: FJS = 100 - ((sum of items / number of items answered) × 25). This results in a 0-100 scale where 100 represents complete joint "forgetting" (best outcome) and 0 represents constant joint awareness (worst outcome). Higher scores indicate better post-surgical outcomes and successful joint replacement. At least 8 of 12 items must be answered for a valid score.
Meaningful Change Threshold
The minimal clinically important difference (MCID) for the FJS ranges from 14 to 20 points depending on the joint and patient population. Changes of 15 points or more are generally considered clinically meaningful. The FJS is known to have ceiling effects in well-functioning patients, with many achieving scores above 80-90 after successful arthroplasty.
Score Interpretation
Understanding what your score means
poor
0 - 24Poor - Joint constantly noticed, significant awareness during most activities
fair
25 - 49Fair - Joint frequently noticed, moderate functional limitations
good
50 - 74Good - Joint occasionally noticed during more demanding activities
very good
75 - 89Very Good - Joint rarely noticed, excellent functional integration
excellent
90 - 100Excellent - Joint almost completely forgotten, minimal to no awareness in daily life
Subscales
This questionnaire measures multiple dimensions
Joint Awareness Total Score (0-100)
Overall measure of the patient ability to forget their artificial joint during daily activities
Clinical Limitations & Considerations
The FJS is specifically designed for patients with joint replacements (arthroplasty) and is not applicable to non-surgical knee or hip conditions. The questionnaire exhibits significant ceiling effects, particularly in highly successful cases where many patients achieve maximum or near-maximum scores. This can limit its ability to discriminate between very good outcomes. The FJS focuses solely on joint awareness and does not assess pain, stiffness, or specific functional limitations. It is subjective and based on patient recall over the previous week. Some activities (e.g., favorite sport) may not be relevant to all patient populations, particularly elderly or less active individuals.
Supporting Literature
Key validation and development studies for the Forgotten Joint Score
- 1
The "forgotten joint" as the ultimate goal in joint arthroplasty: validation of a new patient-reported outcome measure
Behrend H, Giesinger K, Giesinger JM, Kuster MS
The Journal of Arthroplasty, 2012
- 2
Evaluation of joint awareness after acetabular fracture: Validation of the Forgotten Joint Score according to the COSMIN checklist protocol
Thompson SM, Salmon LJ, Waller A, Linklater J, Roe JP, Pinczewski LA
PLoS ONE, 2021
- 3
Reliability and validity of the Hebrew version of the forgotten joint score for assessing the outcomes of total knee arthroplasty
Pansky A, Bar-Ziv Y, Tamir E, Finestone A, Agar G, Shohat N
Arthroplasty, 2021
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This questionnaire is provided free of charge. Patient Watch charges only for platform services (data storage, automated reminders, analytics) - not for use of clinical instruments. This non-commercial model supports academic and clinical use. View full licensing disclosure