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.

Keywords

• Distal biceps
• PROMIS
• Distal biceps rupture
• Elbow
• Outcomes
• Operative