Department of Orthopedics and Sports Medicine, University of Washington Medical Center, Seattle, WA, USA.
Department of Orthopedics and Sports Medicine, University of Washington Medical Center, Seattle, WA, USA.
J Shoulder Elbow Surg. 2022 Aug;31(8):1640-1646. doi: 10.1016/j.jse.2022.02.010. Epub 2022 Mar 19.
Preoperative and postoperative patient self-reported measures are the key to understanding the benefit of shoulder arthroplasty for patients with different diagnoses and having different surgical approaches. The minimal clinically important difference (MCID) for patient-reported outcomes such as the Simple Shoulder Test (SST) is often used to document the amount of improvement that is of importance to the patient; however, the MCID may differ for different types of shoulder arthroplasty. The objective of this study was to report the MCID of the SST and the MCID of the percentage of maximal possible improvement (%MPI) for 5 different arthroplasty types.
Eight hundred eighty-seven patients undergoing shoulder arthroplasty with preoperative SST scores, 2-year postoperative SST scores, and patient satisfaction were included. The sample comprised 368 patients undergoing anatomic total shoulder arthroplasty (aTSA), 330 patients undergoing ream-and-run arthroplasty (R&R), 80 patients undergoing reverse total shoulder arthroplasty (rTSA), 53 patients undergoing cuff tear arthropathy arthroplasty, and 56 patients undergoing hemiarthroplasty. For each type of arthroplasty, the anchor-based method was used for calculating the MCID for both absolute SST scores and %MPI.
Significant improvements in SST values were seen for all arthroplasty types. The MCID for SST change was 2.3 overall but ranged from 1.6 for aTSA, to 2.6 for R&R, to 3.7 for rTSA. The MCID for %MPI was 32% overall but ranged from 22% for aTSA to 42% for hemiarthroplasty. The percentage of patients exceeding the MCID threshold was highest for aTSA at 96% and lowest for hemiarthroplasty at 61%.
The same MCID value may not be appropriate for different types of shoulder arthroplasty. This study reports MCID thresholds that can be used when assessing the effectiveness for each of the common types of shoulder arthroplasty.
术前和术后患者自我报告的测量结果是了解不同诊断和不同手术入路的患者接受肩关节置换术获益的关键。简单肩部测试（SST）等患者报告结果的最小临床重要差异（MCID）通常用于记录对患者重要的改善程度；然而，不同类型的肩关节置换术的 MCID 可能不同。本研究的目的是报告 5 种不同关节置换类型的 SST 的 MCID 和最大可能改善百分比（%MPI）的 MCID。
纳入了 887 例接受肩关节置换术且术前 SST 评分、术后 2 年 SST 评分和患者满意度的患者。该样本包括 368 例接受解剖型全肩关节置换术（aTSA）的患者、330 例接受扩孔型关节置换术（R&R）的患者、80 例接受反式全肩关节置换术（rTSA）的患者、53 例接受肩袖撕裂性关节炎关节置换术的患者和 56 例接受半肩关节置换术的患者。对于每种类型的关节置换术，均使用基于锚定的方法计算 SST 绝对评分和%MPI 的 MCID。
所有关节置换术类型的 SST 值均显著改善。SST 变化的 MCID 总体为 2.3，但范围为 aTSA 的 1.6 至 R&R 的 2.6 至 rTSA 的 3.7。%MPI 的 MCID 总体为 32%，但范围为 aTSA 的 22%至半肩关节置换术的 42%。超过 MCID 阈值的患者百分比在 aTSA 中最高，为 96%，在半肩关节置换术最低，为 61%。
不同类型的肩关节置换术可能不适用相同的 MCID 值。本研究报告了可用于评估常见类型的肩关节置换术每种效果的 MCID 阈值。
