Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, Arizona, U.S.A.
United Hospital Center, West Virginia University, Bridgeport, West Virginia, U.S.A.
Arthroscopy. 2024 Apr;40(4):1066-1072. doi: 10.1016/j.arthro.2023.09.024. Epub 2023 Oct 7.
To evaluate whether there are clinically significant changes in patient-reported outcomes between 1 and 2 years' postoperatively after arthroscopic rotator cuff repair (RCR).
A retrospective analysis of prospective, multicenter registry was queried for all patients who underwent RCR. Patients with preoperative, 6-month, 1-year, and 2-year postoperative American Shoulder and Elbow Surgeons (ASES) scores were included. We evaluated mean postoperative ASES scores, Δ (change from preoperative) ASES, and the %MOI (% maximum outcome improvement). We also evaluated achievement of clinically significant outcomes (CSOs) for the ASES score, including the minimal clinically important difference (MCID), substantial clinical benefit, and patient-acceptable symptom state.
There were 1,567 patients with complete data through 2-year follow-up. There were small differences in achievement of CSOs from 1 to 2 years: 88% to 91% for MCID, 81% to 83% for substantial clinical benefit, and 65% to 71% for patient-acceptable symptom state. There were statistically significant differences from 1 to 2 years in mean ASES (87 to 88, P < .001), Δ ASES (37 to 39, P < .001), and %MOI (72% to 76%, P < .001); however, these changes were well below the MCID of 11.1. From 1 to 2 years, the mean ASES improved only 1.7 points (P < .001). At 1 year, patients achieved, on average, 97% of their 2-year ASES.
Both patient-reported outcomes and achievement of CSOs show small differences at 1 and 2 years after RCR. Given the large sample size, there were statistical differences, but these are unlikely to be clinically relevant.
Level IV, case series.
评估关节镜肩袖修复（RCR）术后 1 至 2 年患者报告的结果是否有临床显著变化。
对前瞻性多中心登记处进行回顾性分析，纳入所有接受 RCR 的患者。包括术前、6 个月、1 年和 2 年术后美国肩肘外科医生（ASES）评分的患者。我们评估了术后平均 ASES 评分、Δ（术前变化）ASES 和%MOI（%最大结果改善）。我们还评估了 ASES 评分的临床显著结果（CSO）的实现，包括最小临床重要差异（MCID）、实质性临床获益和患者可接受的症状状态。
有 1567 名患者在 2 年随访时完成了所有数据。从 1 年到 2 年，CSO 的实现率有较小差异：MCID 为 88%至 91%，实质性临床获益为 81%至 83%，患者可接受的症状状态为 65%至 71%。从 1 年到 2 年，平均 ASES（87 至 88，P<.001）、Δ ASES（37 至 39，P<.001）和%MOI（72%至 76%，P<.001）有统计学显著差异；然而，这些变化远低于 11.1 的 MCID。从 1 年到 2 年，ASES 平均仅改善了 1.7 分（P<.001）。在 1 年时，患者平均达到了他们 2 年 ASES 的 97%。
RCR 后 1 年和 2 年，患者报告的结果和 CSO 的实现都有较小的差异。鉴于样本量大，存在统计学差异，但这些差异不太可能具有临床意义。
IV 级，病例系列。
