Patient-Reported Outcomes Measurement Information System Captures Clinically Meaningful Improvement After Transtibial Pull-Out Repair of Medial Meniscal Posterior Root Tears: Two-Year Outcomes.

Purpose: To (1) establish cohort-specific minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) thresholds for Patient-Reported Outcomes Measurement Information System (PROMIS) values and legacy knee-specific patient-reported outcome measures (PROMs) after isolated medial meniscal posterior root tear (MMPRT) repair using the transtibial pull-out repair technique; (2) determine achievement rates; and (3) analyze correlations among scores.

Methods: Patients undergoing primary isolated MMPRT transtibial pull-out repair with preoperative and minimum 2-year postoperative data were analyzed. PROMs included the PROMIS-Pain Interference (PI) score, PROMIS-Physical Function (PF) score, PROMIS-Depression (D) score, Knee Injury and Osteoarthritis Outcome Score Jr (KOOS Jr), and International Knee Documentation Committee (IKDC) score. Paired 2-tailed Student t tests evaluated PROM changes from preoperatively to postoperatively, with the level of significance at P < .05. MCID thresholds were determined using the distribution-based method, whereas PASS thresholds were anchor based. Pearson correlation coefficients were used to compare PROM scores.

Results: Sixty-eight patients (mean age, 57.2 ± 9.7 years; 75.0% female sex; mean body mass index, 32.2 ± 6.1) were included and followed up for 32.9 ± 10.6 months. From preoperatively to final follow-up, all PROMs significantly improved (P < .05). The MCID thresholds and achievement rates were 6.5 and 63%, respectively, for the PROMIS-PF score; -5.7 and 69%, respectively, for the PROMIS-PI score; -4.8 and 50%, respectively, for the PROMIS-D score; 10.5 and 87%, respectively, for the IKDC score; and 10.3 and 75%, respectively, for the KOOS Jr. The PASS thresholds and rates were 47.8 and 59%, respectively, for the PROMIS-PF score; 53.6 and 54%, respectively, for the PROMIS-PI score; 40.5 and 49%, respectively, for the PROMIS-D score; 67.7 and 66%, respectively, for the IKDC score; and 72.3 and 66%, respectively, for the KOOS Jr. The strongest correlations were observed between the PROMIS-PI score and the KOOS Jr (r = -0.687) and IKDC score (r = -0.660). The PROMIS-D score showed the weakest correlations with the KOOS Jr and IKDC score (r = 0.395 and r = -0.399, respectively). Knee-specific PROMs showed a strong correlation with each other (r = 0.710).

Conclusions: This study establishes cohort-specific MCID and PASS thresholds for the PROMIS subscale scores, IKDC score, and KOOS Jr at a minimum 2-year follow-up after isolated transtibial pull-out MMPRT repair. At 2 years, the MCID and PASS were achieved by 63% and 59% of patients, respectively, for the PROMIS-PF score; 69% and 54%, respectively, for the PROMIS-PI score; and 50% and 49%, respectively, for the PROMIS-D score. For the IKDC score and KOOS Jr, the MCID rates were 87% and 75%, respectively, and the PASS rates were 66% and 66%, respectively.

Level Of Evidence: Level IV, retrospective case series.