Patient-reported outcomes, such as the Patient-Reported Outcomes Measurement Information System (PROMIS) measures, have become increasingly valued as measures of treatment. The purpose of the study was to determine preoperative factors associated with survey compliance 2 years after elective knee surgery. Five hundred patients, age 17 years and older, undergoing knee surgery from August 2015 and March 2017 were administered questionnaires preoperatively and 2 years postoperatively. Questionnaires included the International Knee Documentation Committee (IKDC) score, Numeric Pain Scales (NPS), International Physical Activity Questionnaire (IPAQ), and six PROMIS Domains for physical function, pain interference, social satisfaction, fatigue, anxiety, and depression. Three hundred sixty-five patients (73.0%) completed both the preoperative and the 2-year surveys. A decreased likelihood of survey completion was significantly associated with black race, lower income, government-sponsored insurance, smoking, opioid use, fewer previous surgeries, lower expectations, lower PROMIS social satisfaction, higher PROMIS pain interference, and lower IPAQ physical activity. Multivariable logistic regression analysis confirmed that black race and lower IPAQ activity level were independent predictors of lower survey completion at 2-year follow-up with an area under the curve (AUC) of 0.62. A more robust multivariable model that included all variables with p < 0.05 in the bivariate analysis had an AUC of only 0.70. This study identified multiple preoperative factors that were associated with lower survey completion 2 years after elective orthopaedic knee surgery; however, all the factors measured in this study were not strong predictors of survey completion.

Objective Arthroscopic partial meniscectomy (APM) is one of the most commonly performed surgical procedures. However, the indications for APM are controversial and obese patients may have worse outcomes. This study’s primary purpose was to investigate differences in outcome after APM associated with elevated body mass index (BMI). Secondary objectives included differences in pathophysiology, surgical complications/failures, or osteoarthritis development. Design MEDLINE, EMBASE, and OVID databases were systematically searched for eligible studies reporting on APM outcomes at a minimum of 1 year postoperatively. Studies that did not include BMI categorization were excluded. Meta-analysis was conducted with random-effects modeling where data from at least 2 studies was available. Results A total of 16 articles were included. Overweight/obese BMI was associated with worse preoperative Lysholm (mean difference, −6.06 [95% CI, −11.70 to −0.42]) and visual analogue scale pain scores (0.43 [0.07 to 0.79]). Worse postoperative normalized knee-specific patient-reported outcome scores were also associated with obese BMI (−4.57 [−5.33 to −3.81]). There were no significant differences in clinical improvement or osteoarthritis progression among BMI groups. Two studies found higher complication/failure rates, 3 articles associated medial meniscus posterior root tears, and 1 article found differences in gene transcript expression with increased BMI. Conclusions Obesity is associated with worse knee function after APM, and patients with elevated BMI have worse preoperative knee pain and function. However, there is no difference in amount of improvement between elevated and normal BMI patients. Further prospective research is necessary to determine the comparative effectiveness of APM in patients with elevated BMI.

Background: Patient satisfaction surveys are important measures of the patient experience that provide data for quality improvement. The purpose of this study was to establish the response rate and the factors associated with the completion of the Press Ganey (PG) Ambulatory Surgery Survey (PGAS) in patients who underwent ambulatory upper-extremity surgical procedures. Methods: A prospective orthopaedic registry at a single academic ambulatory surgical center was retrospectively reviewed for patients who underwent an upper-extremity surgical procedure from 2015 to 2019. The institutional PG database was queried to determine the patients who completed the PGAS postoperatively. The response rate was calculated, and baseline characteristics and patient-reported outcome measures were compared between responders and nonresponders. Results: Of the 1,489 patients included, 201 (13.5%) were responders and 1,288 (86.5%) were nonresponders. Differences existed in baseline characteristics between groups, with responders being significantly older (p = 0.004) and having significantly higher proportions of White race (p < 0.001), college education (p = 0.011), employment (p = 0.005), marriage (p = 0.006), and higher income earners (p < 0.001). Responders had significantly better baseline Patient-Reported Outcomes Measurement Information System scores across multiple domains (p < 0.05), but these differences were not clinically meaningful. Conclusions: PGAS response rates were low (13.5%), and differences between responders and nonresponders may be utilized by hospitals to target feedback from underrepresented patient populations. Surgeons, policymakers, and health-care administrators should use caution with the interpretation of PGAS results because responders may not be representative of all patients.

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Aims The purpose of this study was to assess the prevalence of depression and anxiety symptoms in patients undergoing shoulder surgery using the National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) Depression and Anxiety computer adaptive tests, and to determine the factors associated with more severe symptoms. Additionally, we sought to determine whether PROMIS Depression and Anxiety were associated with functional outcomes after shoulder surgery. Methods This was a retrospective analysis of 293 patients from an urban population who underwent elective shoulder surgery from 2015 to 2018. Survey questionnaires included preoperative and two-year postoperative data. Bivariate analysis was used to identify associations and multivariable analysis was used to control for confounding variables. Results Mean two-year PROMIS Depression and Anxiety scores significantly improved from preoperative scores, with a greater improvement observed in PROMIS Anxiety. Worse PROMIS Depression and Anxiety scores were also significantly correlated with worse PROMIS Physical Function (PF) and American Shoulder and Elbow Surgeons scores (ASES). After controlling for confounding variables, worse PROMIS Depression was an independent predictor of worse PROMIS PF, while worse PROMIS Anxiety was an independent predictor of worse PROMIS PF and ASES scores. Conclusion Mean two-year PROMIS Depression and Anxiety scores improved after elective shoulder surgery and several patient characteristics were associated with these scores. Worse functional outcomes were associated with worse PROMIS Depression and Anxiety; however, more severe two-year PROMIS Anxiety was the strongest predictor of worse functional outcomes. Cite this article: Bone Joint J 2022;104-B(4):479–485.