Foong Wei Sheng, Zeng Gerald Joseph, Goh Graham S, Hao Ying, Lie Denny Tjiauw Tjoen, Chang Paul Chee Cheng
Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
SingHealth Health Services Research Center, Singapore.
Orthop J Sports Med. 2022 Jan 4;10(1):23259671211060023. doi: 10.1177/23259671211060023. eCollection 2022 Jan.
The literature on minimal clinically important differences (MCIDs) for patient-reported outcome measures assessing shoulder instability is limited, with none addressing the Oxford Shoulder Instability Score (OSIS). The OSIS was developed to provide a standardized method for assessing shoulder function after surgery for shoulder instability, and previous studies have demonstrated its high reliability, low interrater variability, and ease of administration.
To identify the MCID for the OSIS after arthroscopic Bankart repair for recurrent shoulder instability.
Case series; Level of evidence, 4.
A longitudinally maintained institutional registry was queried for patients who underwent arthroscopic Bankart repair from 2010 to 2016 for recurrent shoulder instability secondary to a Bankart lesion without significant glenoid bone loss. The OSIS was completed preoperatively and at 1 year postoperatively. Patients were categorized into "expectations met" and "expectations unmet" groups using a questionnaire evaluating expectation fulfilment. The MCID of the OSIS at 1 year was calculated using 3 anchor-based approaches and a distribution-based approach. The 3 anchor-based approaches comprised (1) simple linear regression analysis, (2) receiver operating characteristic curve analysis, and (3) calculation of mean differences in change for the OSIS between the "expectations met" and "expectations unmet" groups.
The study cohort comprised 68 men and 11 women aged 29.9 ± 12.7 years (mean ± SD). Duration of follow-up for all patients exceeded 1 year. The MCIDs for the OSIS based on the 4 calculation approaches yielded a narrow range of values, ranging from 7.7 to 8.5 for the anchor-based methods and 8.6 for the distribution-based method.
Study results indicated that patients with recurrent shoulder instability without significant bone loss who undergo primary arthroscopic Bankart repair and have at least 8.6 points of improvement on their OSIS experience a clinically significant change at 1 year postoperatively.
关于评估肩部不稳定的患者报告结局指标的最小临床重要差异（MCID）的文献有限，且尚无针对牛津肩部不稳定评分（OSIS）的研究。OSIS的开发旨在为评估肩部不稳定手术后的肩部功能提供一种标准化方法，先前的研究已证明其具有高可靠性、低评分者间变异性且易于实施。
确定复发性肩部不稳定关节镜下Bankart修复术后OSIS的MCID。
病例系列；证据等级，4级。
查询一个长期维护的机构登记数据库，纳入2010年至2016年因Bankart损伤继发复发性肩部不稳定且无明显肩胛盂骨质丢失而接受关节镜下Bankart修复的患者。术前及术后1年完成OSIS评分。使用一份评估期望达成情况的问卷将患者分为“期望达成”组和“期望未达成”组。采用3种基于锚定的方法和1种基于分布的方法计算术后1年OSIS的MCID。3种基于锚定的方法包括：（1）简单线性回归分析；（2）受试者工作特征曲线分析；（3）计算“期望达成”组和“期望未达成”组之间OSIS变化的平均差异。
研究队列包括68名男性和11名女性，年龄29.9±12.7岁（均值±标准差）。所有患者的随访时间均超过1年。基于4种计算方法得出的OSIS的MCID值范围较窄，基于锚定的方法为7.7至8.5，基于分布的方法为8.6。
研究结果表明，对于无明显骨质丢失的复发性肩部不稳定患者，接受初次关节镜下Bankart修复术后，OSIS至少改善8.6分表明术后1年有临床显著变化。
