The most important results of this study show the diversity of PROMs used in rehabilitation programs after knee surgery. This variety is based on several particularities, namely the number and type of questions/items, the time needed to fill them in, the translations available for each one, the type of sub-scales, the cost/license required for their use, and the time lag in applying the PROMs (Hohmann et al. 2011; Park et al. 2018; Perez et al. 2017; Rolfson et al. 2016). Given this conceptualization and the results obtained in identifying the PROMs used in rehabilitation programs after knee surgery, it is recommended to collect the information reported by the participants through the application of generic and specific PROMs (Moreira et al. 2024; Rolfson et al. 2016).

Generic measures make assessing general health and/or health-related quality of life possible, considering the person’s physical, mental, and socio-cultural aspects (Rolfson et al. 2016). This study identified several generic PROMs, including the EQ5D-5L, HADS, SF-36, SF-12, VR-12, and the AM-PAC. The one most used in rehabilitation after knee surgery was the EQ5D-5L, a descriptive instrument that defines health in five dimensions: mobility, self-care, habitual activities, pain/discomfort, and anxiety/depression (Herdman et al. 2011). It was designed to be self-completed and allows you to assess your general health when filling it out using a vertical visual analogue scale from 0 to 100 (EQ-VAS). In the study carried out by Conner-Spady et al. (2015) on participants proposed for knee surgery, this instrument was considered essential in assessing the dimensions mentioned above, given the high convergent validity in the study population (Conner-Spady et al. 2015). Another of the general PROMs identified in this review was the HADS, which is an asset for researchers/health professionals to interpret emotional and cognitive characteristics related to symptoms of depression and anxiety (Çelebi et al. 2015; Terradas-Monllor et al. 2021). The scale consists of 14 questions, seven of which identify symptoms of depression, and the other seven identify symptoms of anxiety, with total scores ranging from 0 to 42 points. The application of this PROM is essential after knee surgery and during rehabilitation since throughout the recovery process, through the combination of the psychological process and the underpinnings of the fear-avoidance, fear-avoidance beliefs and behaviors are formed that drive some pain-related disability (Terradas-Monllor et al. 2021). The SF-36 was another PROM identified in one of the studies that applied for an exercise program after knee surgery (Hsu et al. 2017), or in a shorter version, the SF-12, which made it possible to assess health-related quality of life in its mental (MCS) and physical (PCS) components (Schache et al. 2019). Since it was developed, this tool has been used for studies in the field of rehabilitation (Moock et al. 2006). In recent years, several rehabilitation research studies have shown that this is a viable tool for measuring the health-related quality of life of patients taking part in rehabilitation programs (Moock et al. 2006; Moreira and Grilo 2019). Hsu et al. (2017) evaluated the eight domains of the SF-36 and showed that exercise improved all the domains of the physical element of the participants after knee surgery and only the domains of the mental component in the control group (Hsu et al. 2017). The VR-12 was one of the PROMs used, allowing the physical and mental components to be assessed in the same way as the SF-12 (Kazis et al. 1998) and emphasizing the usefulness of evaluating the health-related quality of life of participants in telerehabilitation programs after knee surgery (LeBrun et al. 2022). Another of the general PROMs identified, the AM-PAC, has been developed over the years for application in the context of clinical practice and research and is based on the conceptualization defined by the World Health Organization’s International Classification of Functioning, Disability, and Health. This instrument allows for a comprehensive and accurate assessment of functional outcomes related to the participant in an acute and/or post-acute care environment (DeJong et al. 2020).

In addition to generic PROMs, several knee pathology-specific PROMs are also used to measure specific outcomes, and for this study, only those used in rehabilitation programs following knee surgery were considered. The most used was KOOS (Arhos et al. 2020; Barker et al. 2021; Beynnon et al. 2011; Bigouette et al. 2019; Bruun-Olsen et al. 2013; DeJong et al. 2020; Hall et al. 2015; Hill and O’Leary 2013; Hsu et al. 2017; Jakobsen et al. 2014; Johnson et al. 2020; Moffet et al. 2015; Schache et al. 2019), allowing the outcomes to be assessed after self-completion of 42 items: pain (9 items), symptoms (7 items), activities of daily living (17 items), sport and recreation function (5 items), and knee-related quality of life (4 items) (Roos et al. 2024). All items are scored from 0 to 4; for each subscale, the scores are transformed into scales from 0 to 100 (0 representing extreme knee problems and 100 representing no knee problems) (Hsu et al. 2017; Roos et al. 2024). This is a reliable tool for the participants we included in this study, confirmed by statistically significant results when comparing two groups in a rehabilitation program after anterior cruciate ligament surgery (Bigouette et al. 2019; Bruun-Olsen et al. 2013; Hill and O’Leary 2013).

WOMAC was another specific PROMs identified, often used in a rehabilitation program after knee surgery. It consists of 24 items grouped into three dimensions (Terradas-Monllor et al. 2021). A 5-point Likert scale was used to determine the score by the sum of the aggregate scores for the pain, stiffness, and physical function dimensions (Escobar et al. 1982). The TSK-11, GRS (perceived knee function), IKDC-SKF, and KOS-ADLS were also used in at least two studies each (Arhos et al. 2020; Johnson et al. 2020; Terradas-Monllor et al. 2021). These specific PROMs made it possible to measure the effect of the rehabilitation intervention, namely health-related quality of life. The specific PROMs identified in smaller numbers in this study were the IKDC, SOPA-B, LEAS, LKSS, and KOOS-JR, which measure various dimensions, including functional results associated with the knee joint, the evolution of pain, and physical performance throughout the rehabilitation program (Bigouette et al. 2019; Çelebi et al. 2015; LeBrun et al. 2022; Terradas-Monllor et al. 2021). Valuing these dimensions through specific PROMs, namely pain assessment, has been recommended in several studies as one of the aspects that can foster innovation and success in the implementation of interventions since it can make it possible to optimize procedures to reduce the level of chronic pain and improve health-related quality of life (Van Beest et al. 2022).

Analysis of the studies included in this rapid systematic review showed that specific PROMs were selected for a significant population of patients, including those participating in rehabilitation programs following knee surgery (Rolfson et al. 2016), and good measurement properties of the instrument. This rapid review shows the diversity of specific PROMs, which should be used with generic PROMs (Rolfson et al. 2016) to better respond to changes in the condition of interest and other coexisting conditions over time.

This rapid review has some limitations, namely that only English language articles were included. This review included studies from several countries around the world, helping to increase the transferability of the conclusions; however, this can be considered a limitation given the specific context of each country and the different income levels in each country. It would be necessary in future studies to compare program participants and rehabilitation considering the PROMs specific to each type of surgery.