EP8.56 PROMIS Versus Legacy Patient-Reported Outcome Measures in Patients Undergoing Hip Arthroscopy for Symptomatic Femoroacetabular Impingement

Abstract Introduction The Patient-Reported Outcomes Measurement Information System (PROMIS) may offer a more efficient alternative (utilizing computer-adaptive testing) to legacy hip-specific patient-reported outcome measures (PROMs) for patients undergoing hip arthroscopy for symptomatic femoroacetabular impingement (FAI), but its validity and clinical utility in FAI have not been established in a large multicenter cohort. The purpose of the current study was to evaluate the correlation between PROMIS and legacy hip-specific PROMs. Methods A multicenter cohort of 600 patients with FAI undergoing hip arthroscopy was selected. All completed PROMIS and legacy PROM at baseline and 83.3% (500) completed at 1 year postoperatively. PROMIS domains included Physical Function (PF), Pain Interference (PI), Mobility, Anxiety, and Depression. Legacy PROMs included Hip Disability and Osteoarthritis Outcome Score (HOOS) subscales, Modified Harris Hip Score (mHHS), and the International Hip Outcome Tool 12-item (iHOT-12). Floor and ceiling effects were defined as ≥15% achieving the minimum or maximum possible scores. Associations were analyzed using Pearson coefficients (r), and responsiveness using Cohen’s d (d) and relative efficiency (RE). Results The cohort had a mean age of 25.3 ± 8.1 years and 57.9% were female, with a mean follow-up of 1.1 years. At baseline, the strongest correlation was PROMIS-Mobility with HOOS-ADL (r = 0.71, p < 0.001). At 1 year, PROMIS-PI showed the strongest correlations with HOOS-Pain and iHOT-12 (both r = −0.80, p < 0.001), and its change score correlated most strongly with iHOT-12 from baseline to 1 year (r = −0.71, p < 0.001). Most legacy PROMs were more responsive than PROMIS (RE = 0.03–0.78), although PROMIS-PF and PROMIS-Mobility slightly outperformed HOOS-ADL (RE = 1.05 and 1.11, respectively). At 1 year postoperatively, PROMIS-Mobility had the highest ceiling effect (49.4%), while other PROMIS domains showed high minimum-score rates (22.6%–37.7%) and corresponding legacy PROMs showed high maximum-score rates (20.2%–37.0%). Conclusion PROMIS showed similar floor/ceiling effects, weaker responsiveness, and moderate-to-strong correlations with legacy PROMs. However, its limited sensitivity for hip-specific outcomes may limit its ability to replace legacy PROMs in patients with FAI.