Kawakami Junichi, Gotoh Masafumi, Matsuura Koumei, Shin Kunichika, Fujito Ikuhisa, Tanaka Aya, Matsunaga Saho, Imai Takaki, Nagamatsu Takashi, Madokoro Kazuya, Shiba Naoto
1 Department of Orthopedic Surgery, Kurume University School of Medicine Graduate School, Asahi-machi, Kurume, Fukuoka, Japan.
2 Department of Rehabilitation, Saiseikai Yahata General Hospital, Haruno-machi, Kitakyushu, Fukuoka, Japan.
J Orthop Surg (Hong Kong). 2017 May-Aug;25(2):2309499017720002. doi: 10.1177/2309499017720002.
To clarify the cut-off value of the Japanese Orthopaedic Association (JOA) score corresponding to rotator cuff tear outcome as evaluated by the Constant score.
The subjects were 230 patients with rotator cuff tear. The Constant and JOA scores on the first examination in our hospital were evaluated. After investigation of the correlation between the Constant and JOA scores, the cut-off JOA score was calculated, corresponding to excellent, good and fair outcomes as evaluated by the Constant score.
The Constant and JOA scores on the first examination were 49.64 ± 12.84 and 72.52 ± 12.84, respectively, with a strong correlation ( r = 0.87, p < 0.01). Receiver operating characteristic analysis revealed that the cut-off JOA score was 87.0 for excellent outcome (area under the curve, AUC: 0.93; sensitivity: 100%; specificity: 88.6%; p < 0.01), 84.0 for good outcome (AUC: 0.94; sensitivity: 100%; specificity: 83.4%; p < 0.01) and 78.0 for fair outcome (AUC: 0.88; sensitivity: 100%; specificity: 71.3%; p < 0.01).
In patients with rotator cuff tear, good outcome as judged by a Constant score of ≥80 corresponds to a JOA score cut-off of 84.0. Judgement of the treatment outcomes and evaluation of the surgical method may be more accurate when using clear cut-off values for the scoring system employed, such as those determined in our study.
明确日本骨科协会(JOA)评分对应于根据Constant评分评估的肩袖撕裂结果的截断值。
研究对象为230例肩袖撕裂患者。评估患者在我院首次检查时的Constant评分和JOA评分。在研究Constant评分与JOA评分之间的相关性后,计算出对应于根据Constant评分评估为优、良和可结果的JOA评分截断值。
首次检查时的Constant评分和JOA评分分别为49.64±12.84和72.52±12.84,两者具有强相关性(r = 0.87,p < 0.01)。受试者工作特征分析显示,优结果的JOA评分截断值为87.0(曲线下面积,AUC:0.93;敏感度:100%;特异度:88.6%;p < 0.01),良结果的截断值为84.0(AUC:0.94;敏感度:100%;特异度:83.4%;p < 0.01),可结果的截断值为78.0(AUC:0.88;敏感度:100%;特异度:71.3%;p < 0.01)。
在肩袖撕裂患者中,根据Constant评分≥80判断为良结果对应JOA评分截断值为84.0。对于所采用的评分系统使用明确的截断值(如本研究中确定的那些)时,治疗结果的判断和手术方法的评估可能会更准确。