These authors performed a retrospective review of a shoulder arthroplasty database that routinely collects three commonly used patient-reported outcome (PRO) measures in this population: the Simple Shoulder Test (SST), Shoulder Pain and Disability Index (SPADI), and the American Shoulder and Elbow Surgeons (ASES) Assessment Form preoperatively and at 3, 6, 12, and 24months postoperatively. The study was limited to 848 patients undergoing primary shoulder arthroplasty were identified.
Preoperative correlations among PROs were moderate to strong (range, 0.66-0.77). Postoperative correlations were strong for all PRO comparisons (range, 0.73-0.94). Postoperative PRO correlations continued to strengthen over longer follow-up, with all values exceeding 0.78 at 2 years postoperatively.
Comment: These are valuable data because the allow us to determine the percent of maximal possible improvement (%MPI) for anatomic and reverse shoulder arthroplasties. The percent of maximal possible improvement using any outcome measure is calculated as
the improvement: the difference between the postoperative score and the preoperative score
divided by
the maximal possible improvement: the difference between a perfect score and the preoperative score
As can be seen from the graphs below, the %MPI for anatomic and reverse total shoulders is essentially the same, whether measured by the SST, the ASES or the SPADI.
These graphs also show that while in this series of patients each of these procedures lead to significant improvement, neither procedure fully restores the shoulder to normal patient reported comfort and function.
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