Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, U.S.A.
Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Arthroscopy. 2024 Apr;40(4):1081-1088. doi: 10.1016/j.arthro.2023.08.083. Epub 2023 Sep 15.
To determine the minimal clinically important difference (MCID) and the patient acceptable symptom state (PASS) threshold for the visual analog scale (VAS), Constant, Single Assessment Numeric Evaluation (SANE), and American Shoulder and Elbow Surgeons (ASES) scores following arthroscopic capsular release for the treatment of idiopathic shoulder adhesive capsulitis.
A retrospective review of prospective collected data was performed in patients undergoing arthroscopic capsular release for the treatment of idiopathic adhesive capsulitis at a single institution from January 2018 through January 2019. Patient-reported outcome measures were collected preoperatively and 6 months' postoperatively. Delta was defined as the change between preoperative and 6 months' postoperative scores. Distribution-based and anchored-based (response to a satisfaction question at 1 year) approaches were used to estimate MCIDs and PASS, respectively. The optimal cut-off point where sensitivity and specificity were maximized (Youden index) and the percentage of patients achieving those thresholds were also calculated.
Overall, a total of 100 patients without diabetes who underwent arthroscopic capsular release and completed baseline and 6-month patient-reported outcome measures were included. The distribution-based MCID for VAS, Constant, SANE, and ASES were calculated to be 1.1, 10.1, 9.3, and 8.2, respectively. The rate of patients who achieved MCID thresholds was 98% for VAS, 96% for Constant, 98% for SANE, and 99% for ASES. The PASS threshold values for VAS, Constant, and ASES were ≤2, ≥70, ≥80, and ≥80, respectively. The rate of patients who achieved PASS thresholds was 84% for VAS, 84% for Constant, 89% for SANE, and 78% for ASES.
In patients without diabetes and idiopathic adhesive capsulitis, high rates of MCID and PASS thresholds can be achieved with arthroscopic anteroinferior capsular release LEVEL OF EVIDENCE: Level IV, retrospective cohort study.
确定关节镜下囊松解术治疗特发性肩关节粘连性囊炎后视觉模拟评分（VAS）、Constant、单项评估数值评估（SANE）和美国肩肘外科医生（ASES）评分的最小临床重要差异（MCID）和患者可接受的症状状态（PASS）阈值。
对一家医疗机构 2018 年 1 月至 2019 年 1 月期间行关节镜下囊松解术治疗特发性粘连性囊炎的患者进行前瞻性收集数据的回顾性研究。患者术前和术后 6 个月采集患者报告的结果测量值。Delta 定义为术前和术后 6 个月评分之间的差值。分别采用基于分布和基于锚定（1 年后对满意度问题的反应）的方法来估计 MCID 和 PASS。还计算了最佳截断点，即灵敏度和特异性最大化的点（Youden 指数），以及达到这些阈值的患者百分比。
共有 100 例无糖尿病且行关节镜下囊松解术并完成基线和 6 个月患者报告结局测量的患者纳入研究。计算 VAS、Constant、SANE 和 ASES 的基于分布的 MCID 分别为 1.1、10.1、9.3 和 8.2。达到 MCID 阈值的患者比例为 VAS 为 98%，Constant 为 96%，SANE 为 98%，ASES 为 99%。VAS、Constant 和 ASES 的 PASS 阈值分别为≤2、≥70、≥80 和≥80。达到 PASS 阈值的患者比例为 VAS 为 84%，Constant 为 84%，SANE 为 89%，ASES 为 78%。
在无糖尿病和特发性粘连性囊炎的患者中，关节镜下前下囊松解术可达到较高的 MCID 和 PASS 阈值。
IV 级，回顾性队列研究。
