Recovery Curves for Lisfranc ORIF Using PROMIS Physical Function and Pain Interference

Abstract

Objective: To determine the postoperative trajectory and recovery of patients who undergo Lisfranc ORIF using PROMIS physical function (PF) and pain interference (PI). Methods: Design: Retrospective cohort study Setting: Level 1 trauma center Patient Selection Criteria: Patients who underwent Lisfranc ORIF between January 2002 and December 2022 with documented PROMIS PF and/or PI scores after surgery. Outcome Measures and Comparisons: PROMIS PF and PI were mapped over time up to 1 year after surgery. A sub-analysis was performed to compare recovery trajectories between high and low energy injuries. Results: A total of 182 patients were included with average age of 38.7 (SD 15.9) years (59 high energy and 122 low energy injuries). PROMIS PF scores at 0-weeks, 6-weeks, 12-weeks, 24-weeks, and 48-weeks were 30.2, 31.4, 39.2, 43.9, and 46.7, respectively. There was significant improvement in PROMIS PF between 6-12 weeks (p<0.001), 12-24 weeks (p<0.001), and 24-48 weeks (p=0.022). A significant difference in PROMIS PF between high and low energy injuries was seen at 0-weeks (28.4 vs.31.4, p=0.010). PROMIS PI scores, at 0-weeks, 6-weeks, 12-weeks, 24-weeks, and 48-weeks were 62.2, 58.5, 56.6, 55.7, and 55.6, respectively. There was significant improvement in PROMIS PI 0-6 weeks (p=0.016). A significant difference in PROMIS PI between high and low energy injuries was seen at 48-weeks with scores of (58.6 vs. 54.2, p=0.044). Conclusions: After Lisfranc ORIF, patients can expect improvement in physical function up to one year after surgery, with the biggest improvement in PROMIS physical function scores between 6-12 weeks and PROMIS pain interference scores between 0-6 weeks after surgery. Regardless energy type, Lisfranc injuries seem to regain comparable physical function by 6-12 months after surgery. However, patients with higher energy Lisfranc injuries should be counseled that these injuries may lead to worse pain interference at one year after surgery as compared to lower energy injuries. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.