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

Sara Jain; Michael A. McCurdy; Leah E. Henry; Dominic J. Ventimiglia; Sean J. Meredith; Jonathan D. Packer; R. Frank Henn III; Natalie L. Leong

doi:10.1055/a-2712-4349

The Journal of Knee Surgery, Table of Contents

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

¹Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States
Michael A. McCurdy

¹Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States
Leah E. Henry

¹Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States
Dominic J. Ventimiglia

¹Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States
Sean J. Meredith

¹Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States
Jonathan D. Packer

¹Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States
R. Frank Henn III

¹Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States
Natalie L. Leong

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

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

Full Text

References

References
1 Montalvo AM, Schneider DK, Yut L. et al. “What's my risk of sustaining an ACL injury while playing sports?” A systematic review with meta-analysis. Br J Sports Med 2019; 53 (16) 1003-1012
2 Beck NA, Lawrence JTR, Nordin JD, DeFor TA, Tompkins M. ACL tears in school-aged children and adolescents over 20 years. Pediatrics 2017; 139 (03) e20161877
3 Wiggins AJ, Grandhi RK, Schneider DK, Stanfield D, Webster KE, Myer GD. Risk of secondary injury in younger athletes after anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Am J Sports Med 2016; 44 (07) 1861-1876
4 Ithurburn MP, Paterno MV, Ford KR, Hewett TE, Schmitt LC. Young athletes with quadriceps femoris strength asymmetry at return to sport after anterior cruciate ligament reconstruction demonstrate asymmetric single-leg drop-landing mechanics. Am J Sports Med 2015; 43 (11) 2727-2737
5 Culliton SE, Bryant DM, Overend TJ, MacDonald SJ, Chesworth BM. The relationship between expectations and satisfaction in patients undergoing primary total knee arthroplasty. J Arthroplasty 2012; 27 (03) 490-492
6 Chalmers PN, Mall NA, Moric M. et al. Does ACL reconstruction alter natural history?: a systematic literature review of long-term outcomes. J Bone Joint Surg Am 2014; 96 (04) 292-300
7 Harris JD, Abrams GD, Bach BR. et al. Return to sport after ACL reconstruction. Orthopedics 2014; 37 (02) e103-e108
8 Getgood AMJ, Bryant DM, Litchfield R. et al; STABILITY Study Group. Lateral extra-articular tenodesis reduces failure of hamstring tendon autograft anterior cruciate ligament reconstruction: 2-year outcomes from the STABILITY study randomized clinical trial. Am J Sports Med 2020; 48 (02) 285-297
9 Carter HM, Lewis GN, Smith BE. Preoperative predictors for return to physical activity following anterior cruciate ligament reconstruction (ACLR): a systematic review. BMC Musculoskelet Disord 2023; 24 (01) 471
10 Arundale AJH, Cummer K, Capin JJ, Zarzycki R, Snyder-Mackler L. Report of the clinical and functional primary outcomes in men of the ACL-SPORTS trial: similar outcomes in men receiving secondary prevention with and without perturbation training 1 and 2 years after ACL reconstruction. Clin Orthop Relat Res 2017; 475 (10) 2523-2534
11 Hancock KJ, Glass N, Anthony CA. et al. Performance of PROMIS for healthy patients undergoing meniscal surgery. J Bone Joint Surg Am 2017; 99 (11) 954-958
12 Brodke DJ, Saltzman CL, Brodke DS. PROMIS for orthopaedic outcomes measurement. J Am Acad Orthop Surg 2016; 24 (11) 744-749
13 Porter RS, Holt K, Ramchandran RS. Implementation of PROMIS in an optometry clinic. Patient Relat Outcome Meas 2021; 12: 307-312
14 Gregory JJ, Werth PM, Reilly CA, Jevsevar DS. Cross-specialty PROMIS-global health differential item functioning. Qual Life Res 2021; 30 (08) 2339-2348
15 Myhre L, Kellam P, Dekeyser G. et al. Minimal clinically important differences of PROMIS PF in ankle fracture patients. Foot Ankle Int 2022; 43 (07) 968-972
16 Brodke DS, Goz V, Voss MW, Lawrence BD, Spiker WR, Hung M. PROMIS PF CAT outperforms the ODI and SF-36 physical function domain in spine patients. Spine 2017; 42 (12) 921-929
17 Baron JE, Duchman KR, Wolf BR, Westermann RW. PROMIS is a valid patient-reported outcome measure for patients undergoing ACL reconstruction with multi-ligament knee reconstruction and repair procedures. Knee 2021; 28: 294-299
18 Hancock KJ, Glass N, Anthony CA. et al. PROMIS: a valid and efficient outcomes instrument for patients with ACL tears. Knee Surg Sports Traumatol Arthrosc 2019; 27 (01) 100-104
19 Robins RJ, Anderson MB, Zhang Y, Presson AP, Burks RT, Greis PE. Convergent validity of the patient-reported outcomes measurement information system's physical function computerized adaptive test for the knee and shoulder injury sports medicine patient population. Arthroscopy 2017; 33 (03) 608-616
20 Miles M, Nadarajah V, Jauregui JJ. et al. Evaluation of the PROMIS Physical Function Computer Adaptive Test in Patients Undergoing Knee Surgery. J Knee Surg 2020; 33 (08) 810-817
21 Scott EJ, Westermann R, Glass NA, Hettrich C, Wolf BR, Bollier MJ. Performance of the PROMIS in patients after anterior cruciate ligament reconstruction. Orthop J Sports Med 2018; 6 (05) 2325967118774509
22 Chen RE, Papuga MO, Voloshin I. et al. Preoperative PROMIS scores predict postoperative outcomes after primary ACL reconstruction. Orthop J Sports Med 2018; 6 (05) 2325967118771286
23 Gulledge CM, Koolmees D, Smith DG. et al. The PROMIS CAT demonstrates responsiveness in patients after ACL reconstruction across numerous health domains. Orthop J Sports Med 2021; 9 (01) 2325967120979991
24 Hunt D, Zhang T, Koenig S. et al. Predictors of PROMIS physical function at 2 years following knee surgery. J Knee Surg 2022; 35 (05) 521-528
25 Henn III RF, Dubina AG, Jauregui JJ, Smuda MP, Tracy JK. The Maryland Orthopaedic Registry (MOR): design and baseline characteristics of a prospective registry. J Clin Orthop Trauma 2017; 8 (04) 301-307
26 Cook KF, Jensen SE, Schalet BD. et al. PROMIS measures of pain, fatigue, negative affect, physical function, and social function demonstrated clinical validity across a range of chronic conditions. J Clin Epidemiol 2016; 73: 89-102
27 Amtmann D, Cook KF, Jensen MP. et al. Development of a PROMIS item bank to measure pain interference. Pain 2010; 150 (01) 173-182
28 Farrar JT, Young Jr JP, LaMoreaux L, Werth JL, Poole MR. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 2001; 94 (02) 149-158
29 Irrgang JJ, Anderson AF, Boland AL. et al. Development and validation of the International Knee Documentation Committee subjective knee form. Am J Sports Med 2001; 29 (05) 600-613
30 Saleh KJ, Bershadsky B, Cheng E, Kane R. Lessons learned from the hip and knee musculoskeletal outcomes data evaluation and management system. Clin Orthop Relat Res 2004; (429) 272-278
31 Zywiel MG, Mahomed A, Gandhi R, Perruccio AV, Mahomed NN. Measuring expectations in orthopaedic surgery: a systematic review. Clin Orthop Relat Res 2013; 471 (11) 3446-3456
32 Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 1985; (198) 43-49
33 Marx RG, Stump TJ, Jones EC, Wickiewicz TL, Warren RF. Development and evaluation of an activity rating scale for disorders of the knee. Am J Sports Med 2001; 29 (02) 213-218
34 Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42 (02) 377-381
35 Yedulla NR, Tramer JS, Koolmees DS. et al. Preoperative patient-reported outcomes measurement information system computerized adaptive testing (PROMIS CAT) scores predict achievement of minimum clinically important difference following anterior cruciate ligament reconstruction using an anchor-based methodology. Arthrosc Sports Med Rehabil 2021; 3 (06) e1891-e1898
36 Barber FA, Aziz-Jacobo J, Oro FB. Anterior cruciate ligament reconstruction using patellar tendon allograft: an age-dependent outcome evaluation. Arthroscopy 2010; 26 (04) 488-493
37 Webster KE, Feller JA. Younger patients and men achieve higher outcome scores than older patients and women after anterior cruciate ligament reconstruction. Clin Orthop Relat Res 2017; 475 (10) 2472-2480
38 Bjornsen E, Lisee C, Schwartz TA. et al. Improvement trajectories in patient-reported outcomes between males and females after anterior cruciate ligament reconstruction. J Athl Train 2023; 58 (05) 430-436
39 Kiani SN, England P, Gornitzky AL, Renjilian CB, Williams BA, Ganley TJ. Disparate impact: how does social deprivation affect patient-reported outcomes after ACL reconstruction in children and adolescents?. J Pediatr Orthop 2023; 43 (09) 543-548
40 Ziedas A, Castle JP, Abed V. et al. Associating social determinants of health with PROMIS CAT scores and health care utilization after ACL reconstruction. Orthop J Sports Med 2023; 11 (01) 23 259671221139350
41 Randsborg PH, Cepeda N, Adamec D, Rodeo SA, Ranawat A, Pearle AD. Patient-reported outcome, return to sport, and revision rates 7-9 years after anterior cruciate ligament reconstruction: results from a cohort of 2042 patients. Am J Sports Med 2022; 50 (02) 423-432
42 Kendall R, Wagner B, Brodke D. et al. The relationship of PROMIS pain interference and physical function scales. Pain Med 2018; 19 (09) 1720-1724
43 Christodoulou C, Junghaenel DU, DeWalt DA, Rothrock N, Stone AA. Cognitive interviewing in the evaluation of fatigue items: results from the patient-reported outcomes measurement information system (PROMIS). Qual Life Res 2008; 17 (10) 1239-1246