PROMIS outcomes following operative and non-operative treatment of distal biceps ruptures

Abstract

Introduction

Our study sought to determine outcomes of patients who underwent non-operative and surgical treatment of distal biceps ruptures utilizing both PROMIS and Patient Acceptable Symptoms State (PASS).

Methods

This study was a 7-year study performed retrospectively at a single, large academic institution. There were 468 patients included. Treatment method, demographics, PROMIS scores, PASS, and range of motion were noted for each patient for follow-up visits through 12 months. Chi-squared and paired and unpaired t-tests were used for statistical analyses.

Results

There were 243 patients in the non-operative group, while 225 patients underwent primary operative repair. The non-operative cohort showed an average change in PROMIS Pain Interference (PI), Upper Extremity (UE), and Physical Function (PF) scores from initial injury to 12-months follow-up were −1.19 (p = 0.13), 5.10 (p < 0.001), and 3.60 (p < 0.01), respectively. In contrast, this change in PROMIS PI, UE, and PF scores from initial visit to 12-months were −3.24 (p = 0.02), 4.18 (p < 0.01), and 0.01 (p = 0.91), respectively, in the operative cohort. Minimal change in PROMIS UE was observed between 6 and 12 months, indicated a relative plateau by 6 months. PROMIS UE demonstrated minimally clinically important differences (MCID) at 12 months, but not any other time point.

Conclusions

PROMIS PI and PF showed statistically significant changes within the individual treatment groups over the 12-month follow-up period, but largely did not differ between the two groups. Only PROMIS UE met mean clinically important difference at 12-month follow-up and correlated with PASS. PROMIS UE is potentially sensitive enough to detect functional differences following the treatment of a distal biceps injury.