Assessing Minimum Two-Year Follow-Up PROMIS Scores After Total Shoulder Arthroplasty. Is There A Difference Between One- And Two-Year Outcomes?

Document Type

Conference Proceeding

Publication Date

10-21-2024

Publication Title

JSES International

Abstract

Aim: The goal of this study was to determine if there are significant differences in Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE) function and PROMIS Pain Interference (PI) between one and two years after primary shoulder arthroplasty. Background: Historically, academic journals and the United States Food and Drug Administration required 2-year outcomes for publications and approving implants as safe for total shoulder arthroplasty. However, recent literature has challenged this dogma by demonstrating that patients often plateau at 1 year for common PRO’s, such as VAS and ASES. These results have yet to be proven using the Patient Reported Outcome Information System (PROMIS) scores, however. Methods: We retrospectively identified 199 patients from a single-center, multi-surgeon database who underwent primary anatomic and reverse total shoulder arthroplasty from 2017-2022 and had 1-year and 2-year PROMIS scores. Forty-six of these patients had 1- and 2-year follow-up where clinical outcomes were measured. Patients undergoing revision surgeries, hemiarthroplasty, and those lacking both 1-year and 2-year PROMIS scores were excluded. Statistical analysis was done using non-parametric analysis tests such as the Mann-Whitney U Test. A sub-analysis was done on patients with 1- and 2-year clinical follow-up results. Results: In the entire cohort of patients, there was no significant difference in PROMIS UE between 1- and 2-year post-operative scores (p = 0.224). There was statistically significant worsening in PROMIS PI between 1- and 2-years (p = 0.015), with an increase from 55.2 to 56.6. However, this does not reach the minimal clinical important difference of 8 points. Patients with diabetes (N = 54) experienced a statistically significant worsening in PROMIS UE and PROMIS PI between 1 and 2 years compared to patients without diabetes (p = 0.008). Sub-analysis of patients with 1- and 2-year clinical follow-up visits (N = 46) showed no statistical difference in PROMIS UE and PROMIS PI at 2 years (p> 0.05). They also exhibited no significant difference in clinical data such as VAS pain score, range of motion, and strength showed no significant difference between 1- and 2-year data (p > 0.05). Conclusion: Patients undergoing total shoulder arthroplasty demonstrate no significant differences in PROMIS-Upper Extremity and Pain Interference between 1-year and 2-year follow-up. These results suggest that patients likely reach their maximal benefit of PROMIS scores at the 1 year follow up timepoint.

Volume

8

Issue

6

First Page

1334

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