J Knee Surg 2020; 33(09): 903-911
DOI: 10.1055/s-0039-1688780
Original Article

PROMIS Physical Function Correlates with KOOS, JR in Patients with Knee Pain

1   Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas
Andrea Leyton-Mange
1   Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas
Mark H. F. Keulen
1   Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas
Tiffany C. Liu
2   Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California
Stein J. Janssen
3   Department of Orthopaedic Surgery, University of Amsterdam, Amsterdam, The Netherlands
Kevin J. Bozic
1   Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas
W. Randall Schultz
1   Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas
Karl M. Koenig
1   Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas
› Author Affiliations
Funding None.


Using Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS PF) computerized adaptive test instead of the Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS, JR) could reduce question burden for patients with knee pain. We aimed to prospectively determine the correlation between PROMIS PF and KOOS, JR to assess whether PROMIS PF could be a useful alternative measure for both research and clinical care of patients with knee pain. This was a cross-sectional study of 88 patients. We assessed the correlation between PROMIS PF and KOOS, JR using a Pearson's correlation test. Two multivariable linear regression models were used to determine the amount of variation explained by various patient-level factors. There was a strong correlation between PROMIS PF and KOOS, JR (r = 0.74, p < 0.001). KOOS, JR was an independent predictor of PROMIS PF when controlling for patient-level factors (β 0.26; p < 0.001). The results of this study support the idea of using PROMIS PF in place of joint-specific measures such as KOOS, JR for clinical care of patients with knee pain. The level of evidence for this study is Level III.


This study was performed at Dell Medical School at The University of Texas at Austin.

Publication History

Received: 19 February 2019

Accepted: 27 March 2019

Article published online:
15 May 2019

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.

  • References

  • 1 innovation.cms.gov. Overview of CJR Quality Measures, Composite Quality Score, and Pay-For-Performance Methodology. Available at: https://innovation.cms.gov/Files/x/cjr-qualsup.pdf . Accessed February 6, 2019
  • 2 LewinGroup. CMS Bundled Payments for Care Improvement Initiative Models 2–4: Year 2 Evaluation & Monitoring Annual Report 2016; Available at: https://innovation.cms.gov/files/reports/bpci-models2-4-yr2evalrpt.pdf . Accessed February 6, 2019
  • 3 Kraus VB, Jordan JM, Doherty M. , et al. The Genetics of Generalized Osteoarthritis (GOGO) study: study design and evaluation of osteoarthritis phenotypes. Osteoarthritis Cartilage 2007; 15 (02) 120-127
  • 4 Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 1988; 15 (12) 1833-1840
  • 5 Dawson J, Fitzpatrick R, Murray D, Carr A. Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br 1998; 80 (01) 63-69
  • 6 Roos EM, Lohmander LS. The Knee injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes 2003; 1: 64
  • 7 Lyman S, Lee YY, Franklin PD, Li W, Cross MB, Padgett DE. Validation of the KOOS, JR: a short-form Knee Arthroplasty Outcomes Survey. Clin Orthop Relat Res 2016; 474 (06) 1461-1471
  • 8 AAOS. Comprehensive Care for Joint Replacement (CJR). 2019 Available at: http://www.ajrr.net/quality-initiatives-tools/quality-ref/comprehensive-care-for-joint-replacement-cjr . Accessed February 6, 2019
  • 9 Fries JF, Cella D, Rose M, Krishnan E, Bruce B. Progress in assessing physical function in arthritis: PROMIS short forms and computerized adaptive testing. J Rheumatol 2009; 36 (09) 2061-2066
  • 10 Fries JF, Witter J, Rose M, Cella D, Khanna D, Morgan-DeWitt E. Item response theory, computerized adaptive testing, and PROMIS: assessment of physical function. J Rheumatol 2014; 41 (01) 153-158
  • 11 Hancock KJ, Glass N, Anthony CA. , et al. Performance of PROMIS for healthy patients undergoing meniscal surgery. J Bone Joint Surg Am 2017; 99 (11) 954-958
  • 12 Hung M, Stuart AR, Higgins TF, Saltzman CL, Kubiak EN. Computerized adaptive testing using the PROMIS Physical Function item bank reduces test burden with less ceiling effects compared with the short musculoskeletal function assessment in orthopaedic trauma patients. J Orthop Trauma 2014; 28 (08) 439-443
  • 13 Papuga MO, Beck CA, Kates SL, Schwarz EM, Maloney MD. Validation of GAITRite and PROMIS as high-throughput physical function outcome measures following ACL reconstruction. J Orthop Res 2014; 32 (06) 793-801
  • 14 Tyser AR, Beckmann J, Franklin JD. , et al. Evaluation of the PROMIS physical function computer adaptive test in the upper extremity. J Hand Surg Am 2014; 39 (10) 2047-2051.e4
  • 15 Bartlett SJ, Orbai AM, Duncan T. , et al. Reliability and validity of selected PROMIS measures in people with rheumatoid arthritis. PLoS One 2015; 10 (09) e0138543
  • 16 Bernholt D, Wright RW, Matava MJ, Brophy RH, Bogunovic L, Smith MV. Patient Reported Outcomes Measurement Information System scores are responsive to early changes in patient outcomes following arthroscopic partial meniscectomy. Arthroscopy 2018; 34 (04) 1113-1117
  • 17 Broderick JE, Schneider S, Junghaenel DU, Schwartz JE, Stone AA. Validity and reliability of Patient-Reported Outcomes Measurement Information System instruments in osteoarthritis. Arthritis Care Res (Hoboken) 2013; 65 (10) 1625-1633
  • 18 Chang FH, Jette AM, Slavin MD, Baker K, Ni P, Keysor JJ. Detecting functional change in response to exercise in knee osteoarthritis: a comparison of two computerized adaptive tests. BMC Musculoskelet Disord 2018; 19 (01) 29
  • 19 Hung M, Saltzman CL, Greene T. , et al. Evaluating instrument responsiveness in joint function: the HOOS JR, the KOOS JR, and the PROMIS PF CAT. J Orthop Res 2018; 36 (04) 1178-1184
  • 20 Kagan R, Anderson MB, Christensen JC, Peters CL, Gililland JM, Pelt CE. The recovery curve for the Patient-Reported Outcomes Measurement Information System Patient-Reported Physical Function and Pain Interference computerized adaptive tests after primary total knee arthroplasty. J Arthroplasty 2018; 33 (08) 2471-2474
  • 21 Paz SH, Spritzer KL, Morales LS, Hays RD. Evaluation of the Patient-Reported Outcomes Information System (PROMIS(®)) Spanish-language physical functioning items. Qual Life Res 2013; 22 (07) 1819-1830
  • 22 Thorstensson CA, Gooberman-Hill R, Adamson J, Williams S, Dieppe P. Help-seeking behaviour among people living with chronic hip or knee pain in the community. BMC Musculoskelet Disord 2009; 10: 153
  • 23 Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research Electronic Data Capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42 (02) 377-381
  • 24 PROMIS. PROMIS PF Scoring. Available at: http://www.healthmeasures.net/administrator/components/com_instruments/uploads/PROMIS%20Physical%20Function%20Scoring%20Manual.pdf . Accessed February 6, 2019
  • 25 Brodke DS, Goz V, Voss MW, Lawrence BD, Spiker WR, Hung M. PROMIS PF CAT outperforms the ODI and SF-36 physical function domain in spine patients. Spine 2017; 42 (12) 921-929
  • 26 Overbeek CL, Nota SP, Jayakumar P, Hageman MG, Ring D. The PROMIS physical function correlates with the QuickDASH in patients with upper extremity illness. Clin Orthop Relat Res 2015; 473 (01) 311-317
  • 27 Padilla JA, Rudy HL, Gabor JA. , et al. Relationship between the Patient-Reported Outcome Measurement Information System and Traditional Patient-Reported Outcomes for Osteoarthritis. J Arthroplasty 2019; 34 (02) 265-272
  • 28 Hardy R, Cooper R, Aihie Sayer A. , et al; HALCyon study team. Body mass index, muscle strength and physical performance in older adults from eight cohort studies: the HALCyon programme. PLoS One 2013; 8 (02) e56483
  • 29 Weiss E. Knee osteoarthritis, body mass index and pain: data from the Osteoarthritis Initiative. Rheumatology (Oxford) 2014; 53 (11) 2095-2099
  • 30 Woo J, Leung J, Kwok T. BMI, body composition, and physical functioning in older adults. Obesity (Silver Spring) 2007; 15 (07) 1886-1894
  • 31 Paradowski PT, Bergman S, Sundén-Lundius A, Lohmander LS, Roos EM. Knee complaints vary with age and gender in the adult population. Population-based reference data for the Knee injury and Osteoarthritis Outcome Score (KOOS). BMC Musculoskelet Disord 2006; 7: 38
  • 32 Skinner J, Weinstein JN, Sporer SM, Wennberg JE. Racial, ethnic, and geographic disparities in rates of knee arthroplasty among Medicare patients. N Engl J Med 2003; 349 (14) 1350-1359
  • 33 Agaliotis M, Mackey MG, Jan S, Fransen M. Burden of reduced work productivity among people with chronic knee pain: a systematic review. Occup Environ Med 2014; 71 (09) 651-659
  • 34 Bruce B, Fries J, Lingala B, Hussain YN, Krishnan E. Development and assessment of floor and ceiling items for the PROMIS physical function item bank. Arthritis Res Ther 2013; 15 (05) R144
  • 35 Driban JB, Morgan N, Price LL, Cook KF, Wang C. Patient-Reported Outcomes Measurement Information System (PROMIS) instruments among individuals with symptomatic knee osteoarthritis: a cross-sectional study of floor/ceiling effects and construct validity. BMC Musculoskelet Disord 2015; 16: 253
  • 36 Berliner JL, Brodke DJ, Chan V, SooHoo NF, Bozic KJ. Can preoperative patient-reported outcome measures be used to predict meaningful improvement in function after TKA?. Clin Orthop Relat Res 2017; 475 (01) 149-157