Association Between Routine Patient-Reported Outcome Measure Utilization Among Total Joint Arthroplasty Surgeons and...

Patient-reported outcome measures (PROMs) assess quality of care after total joint arthroplasty (TJA) and will be mandatory for reporting by 2027 under the Center for Medicare and Medicare Services. This study evaluated the impact of PROM utilization on achieving minimum clinically important differences (MCID), substantial clinical benefits (SCB), and patients' global impression of change (PGIC) in primary TJA patients.

The study included 7,441 primary TJA patients (4,458 THAs, 2,983 TKAs) who completed preoperative PROMs within 180 days before surgery and postoperative PROMs 270-450 days after surgery. Surgeons were categorized as PROM users or nonusers based on responses to a survey question about how often they referenced preoperative PROMs before recommending surgery. The primary outcome was the proportion of patients achieving MCID, SCB, or reporting at least "much improved" on the PGIC at 1 year. Multiple linear regression was adjusted for patient age, sex, and BMI.

Among TKA patients, PROM users were more likely to achieve SCB (p<0.001; p=0.002), but no significant difference was found for MCID or PGIC. For THA, there were no significant differences between surgeon groups in achieving these measures.

TKA patients whose surgeons referenced PROMs were more likely to achieve SCB, suggesting potential benefits of PROM utilization in this group. The lack of effect in THA may reflect the more predictable satisfaction levels in this population.