Nuts and Bolts of Patient-Reported Outcomes in Orthopaedics

Minji K. Lee, Isabella Zaniletti, Dirk R. Larson, David G. Lewallen, Daniel J. Berry, Hilal Maradit Kremers

Research output: Contribution to journalReview articlepeer-review


Patient-reported outcomes (PROs) are commonly used in orthopaedic clinical practice, comparative effectiveness research (CER), and label claims. In this paper, we provide an overview of PROs, their development, validation, and use in orthopaedic research with examples and conclude with practical guidelines for researchers and reviewers. We discuss considerations for conceptual framework, validity, reliability, factor analysis, and measurement of change with Knee Injury and Osteoarthritis Outcome score (KOOS), as an example. We also describe advantages of instruments developed based on item response theory and statistical analyses for data collected using PRO measures. Please visit the following ( for a video that explains the highlights of the paper in practical terms.

Original languageEnglish (US)
Pages (from-to)616-621
Number of pages6
JournalJournal of Arthroplasty
Issue number4
StatePublished - Apr 2023


  • factor analysis
  • function
  • pain
  • patient reported outcomes
  • quality of life
  • total joint arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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