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Orthopedic Surgery

Training Level

Resident PGY 1


Henry Ford Hospital


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.

Presentation Date


Predictors of Functional Disability in Patients Undergoing Anterior Cruciate Ligament Reconstruction