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J Knee Surg
DOI: 10.1055/a-2712-4349
Original Article

Predictors of 2-Year PROMIS Physical Function After Primary ACL Reconstruction

Authors

  • Sara Jain

    1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States

  • Michael A. McCurdy 

    1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States

  • Leah E. Henry

    1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States

  • Dominic J. Ventimiglia 

    1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States

  • Sean J. Meredith

    1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States

  • Jonathan D. Packer

    1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States

  • R. Frank Henn III 

    1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States

  • Natalie L. Leong 

    1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States

Funding Information This work was supported by a grant from The James Lawrence Kernan Hospital Endowment Fund, Incorporated (BL1941007WS). This work was also supported in part by Career Development Award Number IK2 BX004879 from the United States Department of Veterans Affairs Biomedical Laboratory R&D (BLRD) Service.
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Abstract

The Patient-Reported Outcomes Measurement Information System (PROMIS) is a common patient-reported outcome (PRO) instrument used to evaluate function, pain, satisfaction, and mental health outcomes after surgery. Predictors of 2-year PROMIS physical function (PF) after knee surgery have been previously reported; however, PROMIS PF 2 years after anterior cruciate ligament reconstruction (ACLR) has not been well studied. The aim of this study was to investigate associations and identify predictors of 2-year PROMIS PF after primary ACLR. A prospectively managed orthopaedic registry was queried for patients who underwent primary ACLR between 2015 and 2018. PROs were collected at baseline and 2 years postoperatively, along with self-reported socioeconomic and demographic information. Bivariate analysis was performed to identify associations between baseline characteristics and 2-year PROMIS PF. Multivariate regression analysis was performed to identify predictors of 2-year and 2-year improvement in PROMIS PF. Of 203 eligible patients, 141 patients (70%) completed 2-year surveys and were analyzed. Better 2-year PROMIS PF was associated with student status (p = 0.007), younger age (p = 0.026), lower body mass index (p < 0.001), and lower Charlson Comorbidity Index (p = 0.023). Greater improvement in PROMIS PF at 2 years was associated with private insurance (p = 0.029) and income over $70,000 (p = 0.007). Better baseline PROs were associated with better 2-year PROMIS PF. Younger age (p = 0.003), higher income (p = 0.023), and better baseline PROMIS Fatigue (p < 0.001) were significant predictors of better 2-year PROMIS PF. Additionally, younger age (p = 0.003), higher income (p = 0.029), worse baseline PROMIS PF (p < 0.001), and better baseline PROMIS Fatigue (p < 0.001) were significant predictors of greater 2-year improvement in PROMIS PF. Age, income, and baseline PROMIS Fatigue independently predicted 2-year PROMIS PF and improvement in 2-year PROMIS PF. Though these factors are nonmodifiable, these findings may allow surgeons to more effectively counsel patients preoperatively.

Keywords

patient-reported outcomes - PROMIS - ACL reconstruction - physical function - predictors


Publication History

Received: 28 May 2025

Accepted: 26 September 2025

Article published online:
16 October 2025

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