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PROMIS physical function two weeks following orthopaedic surgery.

Gregory Perraut1, Ali Aneizi1, Vidushan Nadarajah1

  • 1Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA.

Journal of Clinical Orthopaedics and Trauma
|October 1, 2020
PubMed
Summary
This summary is machine-generated.

Patients experience a significant drop in physical function after orthopedic surgery, especially after lower extremity procedures. Early postoperative physical function (PF) is influenced by factors like social satisfaction and preoperative health.

Keywords:
Orthopaedic surgeryPROMISPatient reported outcomesPhysical function

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Area of Science:

  • Orthopaedic Surgery Outcomes
  • Patient-Reported Outcome Measures (PROMs)
  • Postoperative Rehabilitation

Background:

  • Elective orthopaedic procedures aim to restore physical function.
  • Limited data exists on early postoperative physical function reported by patients.
  • Understanding short-term functional recovery is crucial for patient management.

Purpose of the Study:

  • To characterize physical function two weeks after upper and lower extremity orthopaedic surgery.
  • To identify pre-operative factors associated with two-week postoperative physical function.

Main Methods:

  • Prospective enrollment of 435 adult patients undergoing elective orthopaedic surgery.
  • Utilized PROMIS questionnaires (Physical Function, Pain Interference, Fatigue, Social Satisfaction, Anxiety, Depression), joint-specific function, and pain scales.
  • Analyzed data using correlation coefficients, ANOVA, and multivariate linear regression.

Main Results:

  • Mean physical function (PF) score declined significantly from baseline (42.1) to two weeks postoperative (35.5).
  • Lower extremity surgery patients reported lower two-week PF compared to upper extremity patients.
  • Younger age, Hispanic ethnicity, preoperative narcotic use, prior injury, and specific procedures were linked to lower PF; 2-week social satisfaction showed the strongest correlation.

Conclusions:

  • A notable decline in physical function occurs early after orthopaedic surgery, with lower extremity procedures showing a greater deficit.
  • Preoperative physical function and upper extremity surgery independently predicted better two-week functional outcomes.
  • Factors including mental health, pain, and social satisfaction influence recovery, aiding in managing patient expectations.