So thank you. So the first two I'll ask for Dr. Lee about his paper on osteochondral lesions. The question is, are there any scores that you think are better or that we should use and how does that factor in with something like PROMIS? So I think based on the literature search that our group's done, I think the three that were mentioned in the study are most likely the current best available ones that we think. However, having said that, I think in the foot and ankle world, we're doing a lot of research on PROMIS as well. And I think in my opinion, PROMIS is really a better option moving forward. And that's where our group is focusing most of our research now. So the next question, Dr. Mockney, I'll ask you to answer this one. How do you recommend that surgeons who work in non-academic smaller healthcare systems collect PROs when none are currently being collected within their department? Yeah, that's a very, very good question and a very relevant one. From the CMS perspective, which is not super relevant right now, that'll be a hospital measure. So it won't be as much on the individual practice. But for the individual practitioner, there are a number of solutions out there that are even free or on a per surgeon basis with a low subscription rate that can be used at the time of surgical booking. And I've seen this a lot in small practices or solo practices. And these solutions will, you can assign a questionnaire series and it'll fire off after surgery at different time points. So there are options. I'm happy to weigh in afterwards on some of those, but there are a number of industry solutions that you can use that for. If anyone in the audience has further questions, please feel free to come up to the mics or submit via the app. I have a question for Dr. Marmura. So you've demonstrated that the COOS ACL is better for ACL patients than the long form COOS. At this point, what barriers do you see in implementing that in the place of the long COOS as that's currently what everybody's using? Perfect. Thank you for your question. I'm hoping that once this work is published and out there, that people will start utilizing the short form. And because we can get scores from the COOS ACL from that full length version, we can continue to do some analyses and validation work with previous data sets and just keep improving the body of literature to show that it's a better option. And hopefully that will pick up its use. And I think that just the feasibility and the shortened length will be desirable to have that decreased patient burden and make it easier to do the short form versus the long. Yeah. I have another question for Dr. Lansdown. By the way, the SOAS score is missing a P at the beginning. So you've mentioned that the SOAS score is relatively new. Developed in 2019, you said, I mean, we have so many patient reported outcome measures. Can you articulate for us why we need more? I mean, I think, so this score specifically is very valuable because it's that semi-quantitative MRI scoring system. And I think it can give us a chance before we indicate towards a cuff repair in that borderline arthritic patient, you know, should we be looking towards prolonged non-operative treatment or considering reverse arthroplasty at some point? So I think it fits well with our patient reported outcomes in that it's another objective measure of that preoperative status before facing that surgical decision. And last question, Dr. Castle. So for that study on MCID, how is this different from the other studies that were out there? What can we learn from this one? Yeah, so major difference, like you already highlighted that we have an integrated health system where we're routinely collecting these PROMs. And so we're able to get real world data just looking right there and right then. And these patients aren't consented into a study that they don't know they're being watched. And I think that's a valuable resource in itself because that's a bias of a lot of these different studies. That's kind of where I see it. All right, thank you to the presenters. You guys can have a seat. Thank you so much.

osteochondral lesions

PROMIS

PROs

surgical booking

COOS ACL