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How is maximum outcome improvement defined in patients undergoing shoulder arthroscopy for rotator cuff repair: A 1-year follow-up study

Arthroscopy May 15, 2020

Beck EC, Gowd AK, Liu JN, et al. - The present study was undertaken to ascertain the American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), and Constant-Murley subjective score thresholds for achieving maximal outcome improvement (MOI) after arthroscopic rotator cuff repair and to distinguish preoperative prognosticators of reaching the ASES threshold for achieving MOI. Researchers conducted a retrospective cohort study to distinguish patients undergoing rotator cuff repair at a high-volume institution from January 2014 to January 2017 with a 1-year minimum follow-up. They examined patient characteristics, as well as preoperative and postoperative outcome scores. They applied MOI for the ASES and SANE score as previously described, and a receiver operating characteristic curve analysis was applied to ascertain thresholds for percentage of maximal improvements for each outcome measure based on a satisfaction anchor question. Predictors of reaching the ASES threshold for achieving MOI were identified by applying a logistic regression model. Analysis included a total of 220 patients. After arthroscopic rotator cuff repair, achieving 69.5% of maximal ASES score improvement or 75% of maximal SANE score improvement is indicative of achieving patient satisfaction. The results reveal that preoperative variables including workers compensation cases and surgery to the dominant side were prognosticators of not achieving maximal improvement.

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