Document Type

Article

Publication Date

2025

Abstract

Objectives: In hip, knee, and shoulder arthroplasty, there is evidence that using a broader set of Patient-Reported Outcomes Measurement Information System (PROMIS) measures beyond Physical Function and Pain Interference might improve assessment of patient outcomes. However, the utility and responsiveness of PROMIS domains measuring anxiety, fatigue, sleep, and social participation have been minimally investigated in arthroplasty. This retrospective study aimed to determine the 1) responsiveness of seven PROMIS domains and 2) association between change scores for all seven domains and MCID improvement in Physical Function and/or Pain Interference.

Methods: PROMIS domains of Physical Function, Pain Interference, Depression, Anxiety, Fatigue, Sleep Disturbance, and Satisfaction with Participation in Social Roles were collected preoperatively and 3–6 months postoperatively. Analyses included ANOVA, paired t-tests, Cohen’s d, and area under the curve.

Results: All seven PROMIS domains demonstrated responsiveness following surgery, particularly in patients with preoperative scores ≥ ½ or ≥ 1 SD worse than average (effect sizes up to 1.45). Change scores for the five other domains showed poor to moderate discrimination of MCID achievement in Physical Function and Pain Interference (area under the curve.55–.73), suggesting improvement in these domains is relatively independent of improvements in functioning and pain postoperatively.

Conclusion: Including an expanded set of PROMIS measures in arthroplasty is aligned with patient-centered approaches and might add value in understanding recovery and how arthroplasty impacts the overall quality of life. Applying these responsiveness findings and considering relative preoperative impairment could inform conversations regarding expected surgery recovery course and outcomes. Impact statement: This study supports the application of patient-reported outcomes measures beyond just physical functioning in orthopedics, demonstrating also the utility of mental and social domain measures.

Comments

Originally published in Ryan P. Jacobson, Jeff R. Houck, Steven Z. George, Michael P. Bolognesi, Maggie E. Horn, Responsiveness of PROMIS measures for hip, knee, and shoulder arthroplasty, Advances in Patient-Reported Outcomes, Volume 1, Issue 4, 2025, 100303, https://doi.org/10.1016/j.apro.2025.100303.

Published under a Creative Commons License https://creativecommons.org/licenses/by-nc-nd/4.0/

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