Preoperative outcome scores may predict relative improvement from rotator cuff repair
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Key takeaways:
- High preoperative ASES scores were associated with less relative improvement from rotator cuff repair vs. low preoperative scores.
- However, high preoperative scores should not be a contraindication.
Published results showed high preoperative patient-reported outcome scores may be associated with less relative improvement after arthroscopic rotator cuff repair compared with low preoperative scores.
John R. Martin, MD, and colleagues performed a retrospective comparative prognostic trial using data from 348 patients who underwent arthroscopic rotator cuff repair (RCR) between Jan. 1, 2016, and Feb. 1, 2020, with mean follow-up of 1.8 years.
According to the study, patients were categorized into two cohorts based on their preoperative American Shoulder and Elbow Surgeons score: 127 patients with a preoperative ASES score greater than 63 and 221 patients with a preoperative ASES score less than 63. Researchers noted an ASES score of 63 was the optimal cut-off value predictive of achieving substantial clinical benefit.
Martin and colleagues found patients with a preoperative ASES score less than 63 were “significantly more likely” to achieve the minimum clinically important difference (OR = 4.7) and substantial clinical benefit (OR = 6.1) compared with patients with a preoperative ASES score greater than 63. Patients with a score less than 63 also had a higher percent maximum outcome improvement (63% vs. 41%) and change in ASES score (36 vs. 12) compared with patients with a score greater than 63.
However, researchers noted patients with a preoperative ASES score greater than 63 had higher ASES scores at final follow-up (86 vs. 79), higher satisfaction scores (7.4 vs. 6.7) and were more likely to achieve a patient-acceptable symptom state (59% vs. 48%) compared with patients with a score less than 63.
“The data suggest that high preoperative function should not be a contraindication to undergoing RCR,” the researchers wrote in the study.
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