Department of Orthopedic Surgery, The Ohio State University, Columbus, OH, USA.
Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
J Shoulder Elbow Surg. 2019 May;28(5):939-948. doi: 10.1016/j.jse.2018.10.013. Epub 2019 Jan 24.
Outcomes reporting in rotator cuff repair (RCR) literature has been variable. The minimal clinical important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptomatic state (PASS) bridge the gap between statistical significance and clinical relevance.
The American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), Single Assessment Numeric Evaluation (SANE), and Constant-Murley (Constant) scores were collected preoperatively and 1 year postoperatively for patients undergoing RCR between 2014 and 2017. An anchor-based approach was used to calculate the MCID, SCB change, and PASS for the ASES questionnaire.
The study included 288 patients who underwent RCR. The MCID, SCB, and PASS were, respectively, 11.1, 17.5, and 86.7 for ASES, 4.6, 5.5, and 23.3 for the Constant score, and 16.9, 29.8, and 82.5 for the SANE score. Factors associated with reduced odds of achieving MCID were current smoking for ASES (odds ratio, 0.056) and single-row repair for the Constant score (odds ratio, 0.310). Workers' compensation patients had reduced odds of achieving ASES SCB (odds ratio, 0.267) and were associated with reduced odds of achieving PASS by ASES (odds ratio, 0.244), SANE (OR, 0.452), and Constant (odds ratio, 0.313). Lower preoperative scores were associated with achieving MCID and SCB and higher preoperative Constant scores associated with PASS (P < .001).
This study establishes MCID, SCB, and PASS for ASES, Constant, and SANE scores in patients undergoing RCR. Factors associated with failing to achieve clinically significant values included current smoking, single-row repairs, high body mass index, and workers' compensation status.
肩袖修复（RCR）文献中的结果报告一直存在差异。最小临床重要差异（MCID）、实质性临床获益（SCB）和患者可接受的症状状态（PASS）填补了统计学意义和临床相关性之间的空白。
对 2014 年至 2017 年间接受 RCR 的患者，在术前和术后 1 年收集美国肩肘外科医师协会标准化肩部评估表（ASES）、单一评估数值评估（SANE）和 Constant-Murley（Constant）评分。采用锚定法计算 ASES 问卷的 MCID、SCB 变化和 PASS。
本研究纳入了 288 例接受 RCR 的患者。MCID、SCB 和 PASS 分别为 ASES 的 11.1、17.5 和 86.7，Constant 评分的 4.6、5.5 和 23.3，SANE 评分的 16.9、29.8 和 82.5。与 ASES 未能达到 MCID 相关的因素包括当前吸烟（优势比，0.056）和单排修复（Constant 评分，0.310）。工人赔偿患者达到 ASES SCB 的可能性较低（优势比，0.267），并与 ASES（优势比，0.244）、SANE（OR，0.452）和 Constant（优势比，0.313）的 PASS 降低相关。较低的术前评分与达到 MCID 和 SCB 相关，而较高的术前 Constant 评分与 PASS 相关（P<0.001）。
本研究确定了接受 RCR 的患者的 ASES、Constant 和 SANE 评分的 MCID、SCB 和 PASS。与未能达到临床显著值相关的因素包括当前吸烟、单排修复、高体重指数和工人赔偿状况。
