Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA.
Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Am J Sports Med. 2024 May;52(6):1464-1471. doi: 10.1177/03635465241241538. Epub 2024 Apr 8.
Given the variability across populations and settings, defining the MCID and the PASS for the Rowe and ASOSS scores and patients undergoing primary and revision Latarjet it is essential to have accurate benchmarks relevant to these groups when interpreting clinical results.
To determine the minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) thresholds for the visual analog scale (VAS) for pain during sports, Athletic Shoulder Outcome Scoring System (ASOSS), and Rowe scores after primary and revision Latarjet procedures for treatment of shoulder instability.
Cohort study (diagnosis); Level of evidence, 3.
Between January 2018 and January 2020, a retrospective review of 149 patients undergoing primary Latarjet (n = 82) and revision Latarjet (n = 67) to treat shoulder instability was performed in a single institution. Patient-reported outcome measures were collected preoperatively and 1 year postoperatively. The delta was defined as the change between the pre- and postoperative scores. Distribution-based and anchored-based approaches were used to estimate the MCID and the PASS, respectively. The optimal cutoff point and the percentage of patients achieving those thresholds were also calculated.
The distribution-based MCIDs after primary Latarjet were 1.1, 7.5, and 9.6 for the VAS, Rowe, and ASOSS scores, respectively. The rates of patients who achieved the MCID thresholds were 93.9%, 98.7%, and 100% for the VAS, Rowe, and ASOSS scores, respectively. The PASS thresholds after primary Latarjet were ≤1, ≥90, and ≥85 for the VAS, Rowe, and ASOSS scores, respectively. The percentages of patients who achieved PASS thresholds were 82.9%, 89%, and 86.5% for the VAS, Rowe, and ASOSS scores, respectively. The distribution-based MCIDs after revision Latarjet were 0.6, 6.2, and 3.4 for the VAS, Rowe, and ASOSS scores, respectively. The rates of patients who achieved MCID thresholds were 89.3%, 100%, and 100% for the VAS, Rowe, and ASOSS scores, respectively. The PASS thresholds were ≤3, ≥87, and ≥86 after revision Latarjet for the VAS, Rowe, and ASOSS scores, respectively. The rates of patients who achieved the PASS thresholds were 88%, 88%, and 91% for the VAS, Rowe, and ASOSS, respectively.
This study identified useful values for the MCID and PASS thresholds in VAS, Rowe, and ASOSS scores after primary and revision Latarjet procedures for treating shoulder instability. Most patients achieved MCID and PASS benchmarks, indicating successful primary and revision Latarjet procedure outcomes. These metrics can serve as valuable parameters when analyzing parameters in future studies and have the potential to enhance patient care by optimizing treatment strategies and surgical decision making.
鉴于人群和环境的差异，为了定义 Rowe 和 ASOSS 评分以及接受初次和翻修 Latarjet 手术的患者的 MCID 和 PASS，当解释临床结果时，必须有与这些群体相关的准确基准。
确定初次和翻修 Latarjet 手术后治疗肩关节不稳定的视觉模拟量表 (VAS)、运动中疼痛的 Athletic Shoulder Outcome Scoring System (ASOSS) 和 Rowe 评分的最小临床重要差异 (MCID) 和患者可接受症状状态 (PASS) 阈值。
队列研究（诊断）；证据水平，3 级。
在一个机构中，对 2018 年 1 月至 2020 年 1 月期间接受初次 Latarjet（n = 82）和翻修 Latarjet（n = 67）治疗肩关节不稳定的 149 例患者进行了回顾性研究。收集患者术前和术后 1 年的报告结果测量指标。差值定义为术前和术后评分之间的变化。分别使用基于分布和基于锚定的方法来估计 MCID 和 PASS。还计算了最佳截断点和达到这些阈值的患者百分比。
初次 Latarjet 后基于分布的 MCID 分别为 VAS、Rowe 和 ASOSS 评分的 1.1、7.5 和 9.6。达到 MCID 阈值的患者比例分别为 VAS、Rowe 和 ASOSS 评分的 93.9%、98.7%和 100%。初次 Latarjet 后的 PASS 阈值分别为 VAS、Rowe 和 ASOSS 评分的≤1、≥90 和≥85。达到 PASS 阈值的患者比例分别为 VAS、Rowe 和 ASOSS 评分的 82.9%、89%和 86.5%。翻修 Latarjet 后基于分布的 MCID 分别为 VAS、Rowe 和 ASOSS 评分的 0.6、6.2 和 3.4。达到 MCID 阈值的患者比例分别为 VAS、Rowe 和 ASOSS 评分的 89.3%、100%和 100%。翻修 Latarjet 后的 PASS 阈值分别为 VAS、Rowe 和 ASOSS 评分的≤3、≥87 和≥86。达到 PASS 阈值的患者比例分别为 VAS、Rowe 和 ASOSS 的 88%、88%和 91%。
本研究确定了初次和翻修 Latarjet 手术后治疗肩关节不稳定的 VAS、Rowe 和 ASOSS 评分中 MCID 和 PASS 阈值的有用值。大多数患者达到了 MCID 和 PASS 基准，表明初次和翻修 Latarjet 手术的结果成功。这些指标可作为未来研究中分析参数的有价值的参数，并有可能通过优化治疗策略和手术决策来提高患者护理水平。
