PROMIS Scores in Patients with Tibial Plateau Fractures: Characterizing Recovery Over Time.

Abstract

To characterize functional recovery related to Patient-Reported Outcomes Measurement Information System (PROMIS) scores following surgical fixation of tibial plateau fractures. It was hypothesized that improvement may be seen in PROMIS scores up to the two-year timepoint. Design: Retrospective cohort study. Single Level I Trauma Center (2022-2024). Adults who sustained a tibial plateau fracture (AO/OTA 41) treated operatively and completed PROMIS surveys were included. PROMIS-physical function (PF), pain interference (PI), depression, anxiety, global physical health (GPH), and global mental health (GMH). Scores for each domain were compared across timepoints ranging from 2 weeks to 24 months postoperatively. 270 patients met inclusion criteria (mean age 49.1 years [range: 18-88 years], 57.0% male). PROMIS-PF improved from 28.1 at 2 weeks to 40.6 at 1 year (+12.5, p < 0.001) and remained significantly above the two-week postoperative baseline at 2 years (39.7, +11.6, p < 0.001), though no additional change was observed between 1 and 2 years (p = 0.996). PROMIS-PI decreased from 66.1 at baseline to 58.3 at 1 year (-7.9, p < 0.001) and 60.8 at 2 years (-5.3, p = 0.004), with no significant difference between 1 and 2 years (p = 0.767). PROMIS-GPH increased from 37.3 at baseline to 43.8 at 1 year (+6.5, p < 0.001) and remained improved at 2 years (40.8, +3.5, p = 0.044). In contrast, PROMIS-GMH declined from 46.8 at baseline to 42.6 at 2 years (-4.2, p = 0.043). PROMIS-depression (54.6) and anxiety (55.0) scores did not change significantly. Patients with consistent survey participation through 6 months demonstrated significantly lower PROMIS-PF scores at 2 weeks (24.1 vs 28.1, p < 0.001) but significantly higher scores at 6 weeks (34.9 vs 28.6, p < 0.001), 3 months (36.2 vs 31.2, p < 0.001), and 6 months (40.0 vs 36.6, p < 0.001) compared with those with intermittent participation. In patients with operatively treated tibial plateau fractures, patient-reported physical function, pain interference, and global physical health demonstrated statistically and clinically significant improvements over time, most pronounced within the first postoperative year. III.