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Program

Orthopedic Surgery

Training Level

Resident PGY 1

Institution

Henry Ford Hospital

Abstract

Purpose: The primary purpose of this study was to identify the patient-centric factors that contribute to functional disability in patients undergoing ACL reconstruction, in an effort to help guide patient selection, counseling, and optimal timing of surgery. Methods: All patients undergoing ACL reconstruction by two fellowship-trained sports medicine surgeons from July 2017 to September 2018 were included.Preoperative Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive test (CAT) scores for physical function (PROMIS-PF), pain interference (PROMIS-PI), and depression (PROMIS-D) were recorded, as were patient demographic data. The correlation between psychosocial, demographic, and functional outcomes was then analyzed. Results: There were 145 patients (mean age 27 ± 11, 92 males) included in this review. There was a wide range of PROMIS-PF scores (23.2-61.7), PROMIS-PI scores (38.7-78.4), and PROMIS-D scores (34.2-78.1). Preoperative PROMIS-PF scores were negatively correlated with PROMIS-PI (p <0.001), PROMIS-D (p <0.001), and BMI (p = 0.024). Patients who attended physical therapy reported higher preoperative PROMIS-PF scores (p = 0.050), and patients with concomitant meniscal tears on MRI reported lower PROMIS-PF scores (p = 0.044). There was no association found between PROMIS-PF scores and age, sex, smoking status, or median household income. Conclusion: This study demonstrated that depression and pain, measured by PROMIS-D and PROMIS-PI, respectively, were correlated with decreased functional outcomes, measured by PROMIS-PF, in patients undergoing ACL reconstruction. Increased BMI and the presence of meniscal tears negatively influenced functional outcomes. Patients who attended physical therapy before surgery reported increased functional outcomes. PROMIS-PF scores varied widely in patients undergoing ACL reconstruction, and some patients with high scores may be less likely to improve following surgery. Our results lend to a greater understanding of the patient factors that influence PROMIS scores and suggest weight reduction and physical therapy as interventions to improve preoperative function.

Publication Date

5-2019

Predictors of Functional Disability in Patients Undergoing Anterior Cruciate Ligament Reconstruction

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