PROMIS is a Valid Patient-Reported Outcome Measure for Patients undergoing ACL Reconstruction with Multi-ligament Knee Reconstruction and Repair Procedures.

Abstract

BACKGROUND\nThis study aimed to (1) compare PROMIS with previously validated legacy instruments and (2) to assess between group differences of PROMIS PF-CAT [Physical Function Computer Adaptive Test] for patients undergoing isolated primary ACL reconstruction [ACLR] vs. primary ACL reconstruction with additional ligamentous intervention [MLIK].\n\n\nLEVEL OF EVIDENCE\nII; Prospective Cohort Study.\n\n\nMETHODS\nAt a single preoperative timepoint, 42 [MLIK] and 73[ACLR] patients completed: Short Form 36 Health Survey (SF-36) Mental (MCS) and Physical Component Summary (PCS), Knee Injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EuroQol-5 dimensions (EQ-5D) and Marx Knee Scale. Spearman correlation coefficients (non-parametric data) assessed correlations between PROMIS PF-CAT and legacy PROs [Patient-Reported Outcome instruments]. Floor and ceiling effects were assessed using chi-square tests. Between group differences were assessed (Wilcoxon Rank sum test).\n\n\nRESULTS\nPROMIS PF-CAT for the MLIK cohort [Table 2] demonstrated an excellent-good correlation with SF-36 Physical Function (PCS; r\xa0=\xa00.64, p\xa0<\xa00.01), EQ-5D (r\xa0=\xa00.68, p\xa0<\xa00.01), and KOOS Quality of Life (QOL) (r\xa0=\xa00.68, p\xa0<\xa00.01); good correlation with KOOS ADL (r\xa0=\xa00.52, p\xa0=\xa00.01), KOOS Sports (r\xa0=\xa00.44, p\xa0<\xa00.01), KOOS Pain (r\xa0=\xa00.44, p\xa0<\xa00.01) and WOMAC Function (r\xa0=\xa00.52,p\xa0=\xa00.01). PROMIS PF-CAT scores differed for ACL vs. MLIK cohorts (41.9\xa0±\xa06.6 vs. 37.6\xa0±\xa09.0, p\xa0<\xa00.01). PROMIS PF-CAT demonstrated the fewest floor and ceiling effects [Table 4] versus legacy PRO instruments.\n\n\nCONCLUSION\nPROMIS PF-CAT demonstrated strong correlations with previously validated PRO instruments and offers a favorable alternative for patients undergoing ACLR with MLIK repair/reconstruction procedures. Preoperative PROMIS PF-CAT scores were greater for patients undergoing primary ACLR versus MLIK intervention.