Psychometric properties of visual analog scale assessments for function, pain, and strength compared with disease-specific upper extremity outcome measures in rotator cuff repair

Rotator cuff tears are a frequent cause of shoulder pain that often require arthroscopic repair. After surgery an intense and well-studied rehabilitation protocol is needed to obtain the complete recovery of shoulder function. Fifty patients, who sustained arthroscopic rotator cuff repair for symptomatic, atraumatic and full-thickness supraspinatus tendon tear, were involved. According to our rehabilitation protocol, during the first four postoperative weeks, the arm was supported with an abduction sling pillow, and pendulum exercises, table slide and active elbow extension and flexion were conceded. Outcome measures (Oxford shoulder score (OSS), simple shoulder test (SST), patient-reported satisfaction), shoulder function (range of motion (ROM) and muscle strength), and MRI examination were evaluated. The mean OSS score and SST score increased from 16 to 30.2 and from 5.3 to 11.4, respectively. Patient-reported satisfaction was 96%. At 12 months, patients improved ROM and muscle strength. Postoperative passive anterior elevation was 176; external rotation averaged 47; internal rotation was 90. Postoperative muscle strength during anterior elevation was 8.3 ± 2.2 kg, internal rotation 6.8 ± 3 kg, external rotation 5.5 ± 2.3 kg. Five out of seven patients with recurrent tears evaluated their results as satisfactory. They reported improvements in terms of OSS and SST mean scores despite recurrent tears; therefore, they did not undergo revision surgery. The delayed postoperative physical therapy protocol was associated with improvements in the outcome measures and shoulder function compared to the preoperatory state and rotator cuff healing demonstrated by MRI.

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Predictors of disease-specific quality of life after arthroscopic rotator cuff repair

International Orthopaedics ◽

10.1007/s00264-015-2996-z ◽

2015 ◽

Vol 40 (2) ◽

pp. 323-329 ◽

Cited By ~ 4

Author(s):

Arjen Kolk ◽

Nienke Wolterbeek ◽

Kiem Gie Auw Yang ◽

Jacco A. C. Zijl ◽

Ronald N. Wessel

Keyword(s):

Quality Of Life ◽

Rotator Cuff ◽

Rotator Cuff Repair ◽

Arthroscopic Rotator Cuff Repair ◽

Arthroscopic Rotator Cuff ◽

Cuff Repair ◽

Disease Specific

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Preoperative Psychometric Properties of PROMIS Upper Extremity, Pain Interference, and Depression in Bankart Repair and Rotator Cuff Repair (115)

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121s00265 ◽

2021 ◽

Vol 9 (10_suppl5) ◽

pp. 2325967121S0026

Author(s):

Amar Vadhera ◽

Alexander Beletsky ◽

Harsh Singh ◽

Jorge Chahla ◽

Brian Cole ◽

...

Keyword(s):

Rotator Cuff ◽

Upper Extremity ◽

Rotator Cuff Repair ◽

Patient Reported Outcome ◽

Bankart Repair ◽

Orthopedic Procedures ◽

Patient Reported ◽

Ceiling Effects ◽

Cuff Repair ◽

Score Distributions

Objectives: To examine the preoperative and postoperative performance of PROMIS Upper Extremity 2.0 across various orthopedic procedures for the upper extremity. Secondarily, to define susceptibility to pre- and post-operative floor and ceiling effects. Methods: Retrospective analysis of prospectively collected patient-reported outcome (PRO) data was conducted utilizing an electronic outcome registry for procedures between May 2017 and August 2018. Current procedural terminology (CPT) codes were utilized to examine cohorts for various upper extremity orthopedic procedures including Bankart repair and arthroscopic rotator cuff repair (ARCR). Shapiro-Wilks normality testing was used to assess score distributions for normalcy; given non-normal score distributions, Spearman correlation coefficients were calculated for preoperative patient-reported outcome (PRO) scores. Absolute floor and ceiling effects were calculated for each time point based on CPT code. Results: A total of 488 patients were included across Bankart repair (n=109, 29.3 + 12.5 years) and ARCR (n=379, 57.5 + 9.5 years) cohorts. In the Bankart repair cohort, PROMIS PI demonstrate strong correlations with ASES (r=-0.63), Constant (r=-0.75), PROMIS UE (r=-0.75), and the VR6D (r=-0.61). PROMIS Depression (r=0.23 vs. 0.17), SF12 MCS (r=0.34 vs. 0.11), and VR12 MCS (r=0.44 vs. 0.15) exhibited poor correlations with PROMIS PI and UE, respectively. In the ARCR cohort, PROMIS PI scores demonstrated a good correlation with PROMIS UE (r=0.61). Constant (r=0.58 vs. 0.67), VR12 PCS (r=0.58 vs. 0.47), and VR6D (r=0.67 vs. 0.53) exhibited good correlations with both PROMIS PI and UE measures, respectively. No significant absolute floor or ceiling effects were observed for the PROMIS instruments except PROMIS Depression; an absolute floor was noted for both Bankart (n=12, 30%) and ARCR (n=38, 14.7%) groups. Conclusions: PROMIS PI and UE instruments perform comparably to legacy outcome instruments in patients receiving Bankart repair, as well as those receiving ARCR. Furthermore, in both populations, the PROMIS Depression instrument exhibits absolute floor effects, whereas PROMIS PI and UE instruments fail to demonstrate any absolute floor or ceiling effects.

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PROMIS Upper Extremity Underperforms Psychometrically Relative to American Shoulder and Elbow Surgeons Score in Patients Undergoing Primary Rotator Cuff Repair

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2021.10.021 ◽

2021 ◽

Author(s):

Ophelie Lavoie-Gagne ◽

Hailey P. Huddleston ◽

Michael C. Fu ◽

Nabil Mehta ◽

Benedict Nwachukwu ◽

...

Keyword(s):

Rotator Cuff ◽

Upper Extremity ◽

Rotator Cuff Repair ◽

Cuff Repair

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Establishing the Minimal Clinically Important Difference, Patient Acceptable Symptomatic State, and Substantial Clinical Benefit of the PROMIS Upper Extremity Questionnaire After Rotator Cuff Repair

The American Journal of Sports Medicine ◽

10.1177/0363546520964957 ◽

2020 ◽

Vol 48 (14) ◽

pp. 3439-3446

Author(s):

Eric D. Haunschild ◽

Ron Gilat ◽

Michael C. Fu ◽

Tracy Tauro ◽

Hailey P. Huddleston ◽

...

Keyword(s):

Rotator Cuff ◽

Upper Extremity ◽

Clinical Benefit ◽

Rotator Cuff Repair ◽

Minimal Clinically Important Difference ◽

Outcome Measure ◽

Clinically Important Difference ◽

Substantial Clinical Benefit ◽

Clinically Significant ◽

Cuff Repair

Background: The Patient-Reported Outcome Measurement Information System Upper Extremity (PROMIS UE) questionnaire has been validated as an effective and efficient outcome measure after rotator cuff repair (RCR). However, definitions of clinically significant outcomes used in interpreting this outcome measure have yet to be defined. Purpose: To define clinically significant outcomes of the PROMIS UE questionnaire in patients undergoing arthroscopic RCR. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: We reviewed charts of consecutive patients undergoing RCR in our institution between 2017 and 2018 and included patients who were administered the PROMIS UE before surgery and 12 months after surgery. At 12 months postoperatively, patients were asked domain-specific anchor questions regarding their function and satisfaction after surgery, which were then used to determine the minimal clinically important difference (MCID), Patient Acceptable Symptomatic State (PASS), and substantial clinical benefit (SCB) using receiver operating characteristic and area under the curve (AUC) analysis. Univariate and multivariate logistic regression analysis was utilized to identify patient factors associated with clinically significant outcomes. Results: A total of 105 patients with RCR and minimum 12-month postoperative PROMIS UE were included in the analysis. The defined clinically significant outcomes were 4.87 for the MCID using a distribution-based method, 7.95 for the SCB (sensitivity, 0.708; specificity, 0.833; AUC, 0.760), and 39.00 for the PASS (sensitivity, 0.789; specificity, 0.720; AUC, 0.815). Among respondents, 79.0%, 62.9%, and 64.8% achieved the MCID, SCB, and PASS score thresholds, respectively. Workers’ compensation was negatively associated with achievement of the PASS. Lower preoperative PROMIS UE scores were associated with obtaining the MCID (odds ratio [OR], 0.871; P = .001) and the SCB (OR, 0.900; P = .040), whereas higher preoperative scores were predictive of achieving the PASS (OR, 1.111; P = .020). Conclusion: This study defines the clinically significant outcomes for the PROMIS UE after RCR, of which the majority of patients achieved the MCID, PASS, and SCB at 12 months after surgery. These thresholds should be considered in future study design and interpretation of PROMIS UE in patients with RCR.

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Translation, cross-cultural adaptation and validation of the polish version of the Oxford Shoulder Score in patients undergoing arthroscopic rotator cuff repair

Health and Quality of Life Outcomes ◽

10.1186/s12955-019-1263-1 ◽

2019 ◽

Vol 17 (1) ◽

Cited By ~ 2

Author(s):

Agnieszka Bejer ◽

Magdalena Szczepanik ◽

Jędrzej Płocki ◽

Daniel Szymczyk ◽

Marek Kulczyk ◽

...

Keyword(s):

Rotator Cuff ◽

Psychometric Properties ◽

Cultural Adaptation ◽

Rotator Cuff Repair ◽

Oxford Shoulder Score ◽

Sf 36 ◽

Polish Version ◽

Arthroscopic Rotator Cuff ◽

Cuff Repair ◽

Shoulder Score

Abstract Background The Oxford Shoulder Score (OSS) is a simple and reliable, joint-specific, self-reported outcome measure. It can be applied in patients with shoulder disease other than instability. The purpose of this study was to perform a translation, cultural adaptation of the Polish version of the OSS and to evaluate its selected psychometric properties in patients after arthroscopic rotator cuff repair. Methods Sixty-nine subjects participated in the study, with a mean age 55.5 (ranging from 40 to 65 years). The OSS has been translated using the widely accepted guidelines. All patients completed the Polish version of OSS (OSS-PL), the short version of the Disabilities of Arm, Shoulder and Hand Questionnaire (QuickDASH), the Short Form-36 v. 2.0 (SF-36) and the 7-point Global Rating of Change Scale (GRC). Results High internal consistency of 0.96 was found using Cronbach’s alpha coefficient. Reliability of the OSS resulted in Intraclass Correlation Coefficient (ICC) = 0.99, Standard Error of Measurement (SEM) = 1.14 and Minimal Detectable Change (MDC) = 3.15. The validity analysis showed a moderate (General health r = 0.34) to high (Physical role functioning r = 0.82) correlation between the OSS-PL and SF-36 and a high correlation between the OSS-PL and the QuickDASH (r = − 0.92). Conclusions The Polish version of OSS is a reliable and valid, self-reported questionnaire, which can be applied in patients with a rotator cuff tear undergoing reconstruction surgery. The very good psychometric properties of the Polish version of the OSS indicate that it can be used in clinical practice and scientific research.

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Preoperative psychometric properties of Patient-Reported Outcomes Measurement Information System Upper Extremity, Pain Interference, and Depression in Bankart repair and rotator cuff repair

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2021.02.004 ◽

2021 ◽

Author(s):

Amar S. Vadhera ◽

Alexander Beletsky ◽

Harsh Singh ◽

Jorge Chahla ◽

Brian J. Cole ◽

...

Keyword(s):

Information System ◽

Rotator Cuff ◽

Psychometric Properties ◽

Rotator Cuff Repair ◽

Patient Reported Outcomes ◽

Measurement Information ◽

Outcomes Measurement ◽

Patient Reported ◽

Measurement Information System ◽

Cuff Repair

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Outcomes Following the Repair of Isolated Supraspinatus Repairs versus those with Concurrent Subscapularis Repairs (242)

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121s00350 ◽

2021 ◽

Vol 9 (10_suppl5) ◽

pp. 2325967121S0035

Author(s):

Emily Whicker ◽

Jonathan Hughes ◽

Jacob Puyana ◽

Neel Patel ◽

Edna Fongod ◽

...

Keyword(s):

Rotator Cuff ◽

Outcome Measures ◽

Rotator Cuff Repair ◽

External Rotation ◽

Patient Reported Outcome Measures ◽

Rotator Cuff Tears ◽

Supraspinatus Tear ◽

Significant Difference ◽

Patient Reported ◽

Cuff Repair

Objectives: While rotator cuff tears often require repair of the supraspinatus, patients can also have a concurrent tear of the subscapularis requiring repair. Previous smaller studies have shown good clinical outcomes following the repair of the subscapularis and rotator cuff during the same procedure.1 The purpose of this study was to compare clinical outcome measures between patients who had isolated supraspinatus repairs versus those who had a supraspinatus tear with a concurrent subscapularis repair. Methods: A retrospective review of 166 patients who underwent arthroscopic supraspinatus repair with or without a concurrent subscapularis repair between 2013-2018 with a minimum of one-year follow up was performed. Patients were separated into two groups based on their treatment: 100 had an isolated supraspinatus repair (SP) and 66 had both a supraspinatus and subscapularis repair (SB). The primary outcome was revision rotator cuff repair. Secondary outcomes were objective measures such as range of motion (ROM) and strength testing, including flexion (FF), external rotation (ER), and internal rotation (IR), as well as patient-reported outcome measures (PROs) including visual analog pain scale (VAS) and subjective shoulder value (SSV). Outcomes were compared using the Mann- Whitney Test and Fisher’s Exact Test with p<0.05, as the data were not parametric (SPSS, IBM). Results: There was no significant difference in the rate of revision surgery required following isolated supraspinatus repair versus those with a subscapularis repair. Additionally, there were no significant differences between groups for all PROs, all ROM parameters, and all strength parameters (all p > 0.05) (Table 1). Conclusions: The data from this study demonstrated that patients who require a subscapularis repair at the time of their rotator cuff repair can expect similar short term outcomes to those patients who only required repair of their supraspinatus.

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