Ben Hui, Yeom Ji Woong, Kholinne Erica, Guo Jia, Park Ji Yeon, Ryu Seung Min, Koh Kyoung-Hwan, Jeon In-Ho
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Department of Orthopaedic Surgery, Gangbook Yonsei Hospital, Seoul, South Korea.
Knee Surg Sports Traumatol Arthrosc. 2024 Apr;32(4):1038-1048. doi: 10.1002/ksa.12128. Epub 2024 Mar 13.
This study aimed to evaluate patient-reported outcome measures (PROMs) and the effects of gender and age on achieving clinically significant outcomes in patients undergoing arthroscopic superior capsular reconstruction (ASCR) with a minimum 2-year follow-up.
Patients undergoing ASCR for irreparable rotator cuff tear between 2013 and 2020 were reviewed. Preoperative and minimum 2-year postoperative PROMs were collected, including American Shoulder and Elbow Surgeons (ASES), Constant, single assessment numeric evaluation (SANE), and visual analog scale (VAS) scores. Minimal clinically important difference (MCID) and patient-acceptable symptomatic state (PASS) were calculated for each functional score and analyzed according to age and gender. The percentages of patients achieving MCID and PASS were recorded.
The study included 83 patients, with a mean follow-up of 3.5 ± 1.4 years. Significant improvements were found in ASES, Constant, SANE, and VAS for all groups based on gender and age. Based on receiver-operating characteristic curves, all scores had acceptable areas under the curve for PASS. Values for PASS and MCID were 81.5 and 10.3 for ASES; 61.5 and 6.2 for Constant; 82.5 and 11.5 for SANE and 1.5 and 1.1 for VAS, respectively. Analysis of achieving MCID and PASS showed no difference between the groups in the majority of outcome measures. However, female patients achieved the SANE thresholds for PASS at significantly higher rates than male patients. Patients ≥65 years old achieved ASES and Constant thresholds for MCID at significantly higher rates than patients ˂65 years old.
Most patients achieved MCID and PASS at a 2-year follow-up. Patients showed comparable rates of MCID and PASS achievement on most outcome tools based on age and gender. Female patients achieved PASS on SANE at significantly higher rates than male patients and older patients achieved MCID on ASES and Constant at higher rates than young patients. Thus, age is a stronger factor for achieving MCID than gender.
Level II.
本研究旨在评估患者报告的结局指标（PROMs）以及性别和年龄对接受关节镜下上盂唇重建术（ASCR）且随访至少2年的患者取得临床显著疗效的影响。
回顾2013年至2020年间因不可修复的肩袖撕裂而接受ASCR的患者。收集术前和术后至少2年的PROMs，包括美国肩肘外科医师学会（ASES）评分、Constant评分、单项评估数值评定（SANE）以及视觉模拟量表（VAS）评分。计算每个功能评分的最小临床重要差异（MCID）和患者可接受的症状状态（PASS），并根据年龄和性别进行分析。记录达到MCID和PASS的患者百分比。
该研究纳入83例患者，平均随访3.5±1.4年。基于性别和年龄的所有组在ASES、Constant、SANE和VAS评分方面均有显著改善。根据受试者工作特征曲线，所有评分在PASS方面的曲线下面积均可接受。ASES的PASS和MCID值分别为81.5和10.3；Constant的分别为61.5和6.2；SANE的分别为82.5和11.5；VAS的分别为1.5和1.1。对达到MCID和PASS的分析表明，在大多数结局指标中，各亚组之间无差异。然而，女性患者达到SANE的PASS阈值的比例显著高于男性患者。65岁及以上患者达到ASES和Constant的MCID阈值的比例显著高于65岁以下患者。
大多数患者在2年随访时达到MCID和PASS。基于年龄和性别的大多数结局工具上，患者达到MCID和PASS的比例相当。女性患者在SANE上达到PASS的比例显著高于男性患者，老年患者在ASES和Constant上达到MCID的比例高于年轻患者。因此，年龄是实现MCID比性别更强的因素。
二级。
