Longitudinal Evaluation of Patient-reported Outcomes Measurement Information System (PROMIS) Scores in Children Under 6 With Legg-Calvé-Perthes Disease: A Multicenter Study.

BACKGROUND

Legg-Calvé-Perthes Disease (LCPD) is an idiopathic ischemic hip disorder that can lead to significant impairments in children. Despite representing a substantial portion of LCPD patients, children under 6 remain understudied. This study evaluates longitudinal PROMIS scores in children diagnosed with LCPD before age 6.

METHODS

This multicenter prospective cohort included children diagnosed with LCPD at age 6 or younger between February 2017 and July 2023. PROMIS T-scores (mobility, pain interference, fatigue, depression, anxiety, anger, and peer relationships) were analyzed alongside the Waldenström stage at the time of assessment using linear mixed-effects regression models, adjusting for demographics and interventions.

RESULTS

Among 188 hips in 181 children (median age 4.6 y, 81% male, 79% Caucasian) across 11 institutions, 810 PROMIS surveys were included. The mean and median follow-up was 1.9 years. At stage I, all domains showed mild impairment except depression and fatigue, which remained normal. Pain interference and anger normalized by stage iia, mobility by stage IIIa, and anxiety by stage IIIb (P<0.05).

CONCLUSIONS

In children under 6, PROMIS T-scores showed significant improvements across domains as patients progressed through Waldenström stages. These findings provide insight into how PROMIS T-scores evolve with disease stage, helping clinicians guide families on expected outcomes and set realistic expectations.

LEVEL OF EVIDENCE: Level II-prognostic.