Defining the Patient Acceptable Symptom State (PASS) for PROMIS After Hallux Valgus Correction Surgery

Area of Science:

• Orthopedic Surgery
• Patient-Reported Outcomes
• Foot and Ankle Surgery

Background:

• The patient acceptable symptom state (PASS) defines the minimum symptom level for surgical outcome satisfaction.
• PASS thresholds are established in orthopedics but not yet for hallux valgus (HV) deformity.
• This study aimed to define PASS thresholds using PROMIS scores for HV surgery.

Purpose of the Study:

• To establish patient acceptable symptom state (PASS) thresholds for hallux valgus (HV) deformity correction.
• To utilize Patient-Reported Outcome Measurement Information System (PROMIS) scores to define these thresholds.
• To aid in surgical decision-making and patient counseling for HV surgery.

Main Methods:

• Retrospective review of 286 patients undergoing HV correction.
• PASS thresholds determined using 2-year postoperative PROMIS scores and Likert scale anchor questions.
• Statistical analysis compared demographics and surgical factors influencing PASS achievement.

Main Results:

• PASS thresholds for HV surgery ranged from 41.6 to 65.1 across PROMIS domains.
• Key thresholds: PROMIS Physical Function (PF) 50.3, Pain Intensity (PIntens) 41.5.
• 71-72% of patients met PASS for PF and PIntens; higher preoperative PROMIS and lower BMI improved outcomes.

Conclusions:

• Established PASS thresholds can guide foot and ankle surgeons in HV treatment planning.
• These findings aid in counseling patients regarding satisfactory outcomes post-HV surgery.
• Results provide objective benchmarks for surgical success in hallux valgus correction.