AI Article Synopsis

  • The study aimed to assess changes in patient-reported outcomes one and two years after arthroscopic rotator cuff repair (RCR).
  • A total of 1,567 patients were analyzed for their American Shoulder and Elbow Surgeons (ASES) scores, revealing minor improvements in clinically significant outcomes (CSOs) from year one to year two, but these changes were not substantial enough to be clinically meaningful.
  • While statistical improvements were evident in ASES scores and other metrics, they remained below the minimal clinically important difference (MCID), indicating that the changes may not have a significant impact on patient experience.

Article Abstract

Purpose: To evaluate whether there are clinically significant changes in patient-reported outcomes between 1 and 2 years' postoperatively after arthroscopic rotator cuff repair (RCR).

Methods: 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.

Results: 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.

Conclusions: 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 Of Evidence: Level IV, case series.

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Source
http://dx.doi.org/10.1016/j.arthro.2023.09.024DOI Listing

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