Responsiveness of Patient Reported Outcomes in Shoulder Arthroplasty: What Are We Actually Measuring?
These authors reviewed studies on primary anatomic and reverse total shoulder arthroplasty for glenohumeral arthritis from PubMed, SportDiscus, Cochrane, and CINAHL with an emphasis on studies that reported preoperative and minimum 2 year postoperative scores.
Anatomic TSA was evaluated in 35 studies, reverse TSA in 32 studies, and both anatomic and reverse in 7 studies.
There were a total of 7,624 patients and 25 different patient reported metrics (PRMs) were utilized.
Some of data from their table
are summarized in the chart below
In this chart, the numbers below the PRM reflect the average percent of maximal improvement (%MPI) for each score. It is determined by dividing the difference between the postop and the preop score (the amount of improvement) by the difference between a perfect score and the preoperative score (the maximum amount of improvement possible). This is a convenient way to discuss with patients the average outcomes that have been achieved in the reported studies. For example, patients can be informed that the average SST score improved by over 75% of the maximum possible improvement.
Of course patients are most interested in the improvement that their own surgeon has achieved in her or his own practice (rather than what has been achieved in some remote center). To give a reliable response, each surgeon needs to collect their own data using a reliable and responsive PRM that enables the efficient and convenient collection of data on the largest number of patients. Thus, the optimal approach is a short, validated mailed-in questionnaire - such as the SST or ASES - that does not require either a return visit to the office for measurements or access to and mastery of a computer interface.
Our approach to total shoulder arthroplasty is shown in this
link.
To subscribe to this blog, enter your email in the box to your right that looks like the below
===
How you can support research in shoulder surgery Click on this link.
We have a new set of shoulder youtubes about the shoulder, check them out at this link.
Be sure to visit "Ream and Run - the state of the art" regarding this radically conservative approach to shoulder arthritis at this link and this link
Use the "Search" box to the right to find other topics of interest to you.
