Correlation of Patient Reported Outcome Measurement Information System Computer Adaptive Test (PROMIS-CAT) and Knee Injury and Osteoarthritis Outcome Score (KOOS) in Knee Osteotomy and Cartilage Procedures

Abstract

Objectives:PROMIS-CAT is a novel and efficient method for obtaining patient reported outcomes. Since its inception in 2007, PROMIS has been validated for several body joints, but correlations between PROMIS and orthopaedic legacy measures (i.e., KOOS) have not been evaluated for many knee procedures. The purpose of this study was to determine whether the PROMIS-CAT tool demonstrates correlation with KOOS for patients undergoing either osteotomy or cartilage procedures of the knee.Methods:After obtaining IRB approval, patients were identified who had undergone elective osteotomy (Tibial Tubercle Osteotomy [TTO], High Tibial Osteotomy [HTO], Distal Femoral Osteotomy [DFO]) and/or cartilage restoration (microfracture, DeNovo NT, Osteochondral Allograft Implantation [OCA], Autologous Chondrocyte Implantation [ACI], and meniscal transplant) procedures performed by a single surgeon. Eligible patients completed a series of outcome questionnaires including same day PROMIS-CAT for pain, mobility, physical function and KOOS domains for daily living, pain and sports and recreation. The scores were collected prospectively. Statistical analysis was performed using Spearman’s rank correlations.Results:A total of 212 data points (97 osteotomy, 53 cartilage, 62 combined) were identified to be used in the statistical analysis. Spearman’s rank correlations of all patient scores collected between PROMIS Pain and KOOS Pain (for Pain), PROMIS Mobility and KOOS Daily Living (for Mobility and Living), and PROMIS Physical Function and KOOS Sports and Recreation (for Activity) produced rho values of -0.841, 0.816 and 0.715, respectively. Among osteotomy only patients, Pain scores, Mobility and Living scores and Activity scores correlated with a rho value of -0.828, 0.776, and 0.701, respectively. In patients undergoing cartilage procedures who did not have an osteotomy procedure performed, Pain scores, Mobility and Living scores and Activity scores correlated with a rho value of -0.784, 0.860, and 0.651, respectively. Patients undergoing both osteotomy and cartilage procedures had Pain scores, Mobility and Living scores and Activity scores correlate with rho values of -0.826, 0.830, and 0.732, respectively.Conclusion:The PROMIS-CAT tool was found to correlate well with KOOS domains for patients undergoing osteotomy and/or cartilage procedures of the knee. PROMIS-CAT can be considered as an efficient and reliable method of collecting patient outcomes in this patient population. Advantages include reduced collection time and less of a ceiling effect than legacy outcome scores.