Outcomes assessment in rotator cuff pathology: what are we measuring?

Makhni, Eric C.; Steinhaus, Michael E.; Morrow, Zachary S.; Jobin, Charles M.; Verma, Nikhil N.; Cole, Brian J.; Bach, Bernard R.

doi:10.1016/j.jse.2015.08.007

Cited by 65 publications

(55 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This methodology has been used in several prior studies and was chosen to focus inclusion on high-impact orthopaedic literature. 1,2,7,8 Six cardinal domains were considered in this literature review, comprising reporting of outcomes related to pain, satisfaction, objective knee function, subjective knee function, patientreported outcomes (PROs), and progression of degenerative joint disease. Any article related to surgical treatment of patients with focal articular cartilage defects of the knee was included for review.…”

Section: Methodsmentioning

confidence: 99%

“…Fewer than one-fifth of studies reported on objective clinical findings during follow-up. Other measurements (asterisk) were as follows: patellar translation (1), threerepetition maximum straight leg raise (1), hamstring-quadriceps (HS-quad) strength ratio (1), effusion level (1), assessment of jumping on 1 leg (1), assessment of climbing stairs (1), and assessment of crouching(1). The aforementioned numbers in parentheses refer to the number, not percentage, of studies focusing on each surgical technique.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Comprehensiveness of Outcome Reporting in Studies of Articular Cartilage Defects of the Knee

Makhni

Meyer

Saltzman

et al. 2016

Arthroscopy: The Journal of Arthroscopic & Related Surgery

Self Cite

View full text Add to dashboard Cite

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Comprehensiveness of Outcome Reporting in Studies of Articular Cartilage Defects of the Knee

Makhni

Meyer

Saltzman

et al. 2016

Arthroscopy: The Journal of Arthroscopic & Related Surgery

Self Cite

View full text Add to dashboard Cite

“…10 Such variability creates challenges in comparing results from different studies and therefore with truly understanding outcomes after treatment. 17,20 In addition, the lack of standardization will make incorporation of PROs into value-based reimbursement models challenging for both providers and payers.…”

Section: Discussionmentioning

confidence: 99%

“…It is important to note, however, that multiple domains were included in individual questions, therefore allowing for an efficiency score of >1. In contrast, the ASES, which is the most commonly utilized PRO for rotator cuff tears, 10 only had mediocre efficiency. Moreover, when compared with the Constant score, the UCLA is more comprehensive and efficient; therefore, this would indicate that the UCLA score should be preferentially utilized over the Constant score.…”

Section: Discussionmentioning

confidence: 99%

“…They reported that the 3 most commonly studied outcomes were the Constant, DASH, and SPADI scores. The authors reported that, despite common utilization in clinical studies, 10 both the ASES and the Constant scores had poor background data regarding several important validity characteristics of the tools. Moreover, the authors reported that, of the 16 tools assessed that were utilized in the literature for rotator cuff disease, only the WORC and the quality of life (RC-QoL) measures were actually designed for use in patients with this diagnosis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

How Comprehensive and Efficient Are Patient-Reported Outcomes for Rotator Cuff Tears?

Makhni

Hamamoto

Higgins

et al. 2017

Orthopaedic Journal of Sports Medicine

Self Cite

View full text Add to dashboard Cite

Background:Increasing emphasis is placed on patient-reported outcomes (PROs) after common orthopaedic procedures as a measure of quality. When considering PRO utilization in patients with rotator cuff tears, several different PROs exist with varying levels of accuracy and utilization.Hypothesis/Purpose:Understanding which disease-specific PRO may be most efficiently administered in patients after rotator cuff repair may assist in promoting increased patient and physician adoption of these useful scores. Using a novel assessment criterion, this study assessed all commonly used rotator cuff PROs. We hypothesize that surveys with fewer numbers of questions may remain comparable (with regard to comprehensiveness) to longer surveys.Study Design:Systematic review.Methods:Commonly utilized rotator cuff PROs were analyzed with regard to number of survey components, comprehensiveness, and efficiency. Comprehensiveness (maximum score, 11) was scored as the total number of pain (at rest/baseline, night/sleep, activities of daily living [ADLs], sport, and work) and functional (strength, motion/stiffness, and ability to perform ADLs, sport, and work) metrics included, along with inclusion of quality of life/satisfaction metrics. Efficiency was calculated as comprehensiveness divided by the number of survey components.Results:Sixteen different PROs were studied. Number of components ranged from 5 (University of California at Los Angeles score [UCLA]) to 36 (Short Form–36 [SF-36], Japanese Orthopaedic Association score [JOA]). The Quality of Life Outcome Measure for Rotator Cuff Disease (RC-QoL) included all 5 pain components, while 7 PROs contained all 5 functional components. Ten PROs included a quality of life/satisfaction component. The most comprehensive scores were the RC-QoL (score, 11) and Penn (score, 10), and the least comprehensive score was the Marx (score, 3). The most efficient PROs were the UCLA, the Quick Disabilities of the Arm, Shoulder, and Hand score (QuickDASH), and Constant scores. The least efficient scores were the JOA and SF-36 scores.Conclusion:Many commonly utilized PROs for rotator cuff tears are lacking in comprehensiveness and efficiency. Continued critical assessment of PRO quality may help practitioners identify the most comprehensive and efficient PRO to incorporate into daily clinical practice.

show abstract

Low level of evidence for all treatment modalities for irreparable posterosuperior rotator cuff tears

Kooistra

Gurnani

Weening

et al. 2019

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose This systematic review assesses evidence for improvements in outcome for all reported types of treatment modalities [physical therapy, tenotomy or tenodesis of the long head of the biceps, debridement, partial repair, subacromial spacer, deltoid lap, muscle transfer, rotator cuf advancement, graft interposition, superior capsular reconstruction (SCR), and reversed shoulder arthroplasty (RSA)] used for irreparable posterosuperior rotator cuf tears without glenohumeral osteoarthritis. The primary aim was to be able to inform patients about expectations of the amount of clinical improvement after these treatments. Methods A systematic search was conducted in MEDLINE, EMBASE, CINAHL, and Cochrane databases for studies on irreparable posterosuperior rotator cuf lesions without glenohumeral osteoarthritis, published from January 2007 until January 2019, with minimum 2-year follow-up. Studies with pre-operative and/or intra-operative determination of cuf tear irreparability were included. We deined the non-adjusted Constant Score as the primary outcome. Results Sixty studies (2000 patients) were included with a fair mean quality score, according to the Modiied Coleman Methodology Score. The employed deinitions of 'irreparable' were mainly based on MRI criteria and were highly variable among studies. The smallest weighted mean preoperative to post-operative improvements in Constant Score were reported for biceps tenotomy/tenodesis (10.7 points) and physical therapy (13.0). These were followed by debridement (21.8) and muscle transfer (27.8), whereas the largest increases were reported for partial repair (32.0), subacromial spacer (32.5), rotator cuf advancement (33.2), RSA (34.4), graft reconstruction (35.0), deltoid lap (39.8), and SCR (47.4). Treatment using deltoid lap showed highest mean weighted improvement in Constant Score among studies with available medium-term (4-5-year) follow-up. Treatments deltoid lap, muscle transfer, and debridement were the only treatments with available long-term (8-10-year) follow-up and showed similar improvements in Constant Score at this time point. ConclusionThe variability in patient characteristics, co-interventions, outcome reporting, and length of follow-up in studies on irreparable rotator cuf tears without osteoarthritis complicates sound comparison of treatments. Clinically important treatment efects were seen for all 11 diferent treatment modalities. Level of evidence IV.

show abstract

Outcomes assessment in rotator cuff pathology: what are we measuring?

Cited by 65 publications

References 20 publications

Comprehensiveness of Outcome Reporting in Studies of Articular Cartilage Defects of the Knee

Comprehensiveness of Outcome Reporting in Studies of Articular Cartilage Defects of the Knee

How Comprehensive and Efficient Are Patient-Reported Outcomes for Rotator Cuff Tears?

Low level of evidence for all treatment modalities for irreparable posterosuperior rotator cuff tears

Contact Info

Product

Resources

About