Single Assessment Numeric Evaluation (SANE) is a reliable metric to measure clinically significant improvements following shoulder arthroplasty

Gowd, Anirudh K.; Charles, Michael D.; Liu, Joseph N.; Lalehzarian, Simon P.; Cabarcas, Brandon C.; Manderle, Brandon J.; Nicholson, Gregory P.; Romeo, Anthony A.; Verma, Nikhil N.

doi:10.1016/j.jse.2019.04.041

Cited by 99 publications

(81 citation statements)

References 31 publications

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“…Our data showed statistically significant changes in ASES and SANE scores; both also represented minimal clinically important differences (MCIDs) in PROs as reported in the current MCID literature. The MCID for the ASES score ranges from 6.4-17 (MCID of 23 in our study), and the MCID for the SANE score after shoulder arthroplasty was most recently defined as 28.8 (MCID of 48 in our study), 4 , 6 , 18 illustrating both statistical and, more important, clinical significance. PROs more likely reflect the outcome of the procedure and do not necessarily reflect the use of suture cerclage cables.…”

Section: Discussionmentioning

confidence: 53%

Suture cerclage for stabilizing the humeral shaft during shoulder arthroplasty

Eyberg¹,

Walker²,

Harmsen³

et al. 2020

JSES International

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Background In shoulder arthroplasty, cerclage fixation techniques are used to stabilize osteotomies, fractures, and allografts. Fixation techniques including cerclage with metal and polymer cables have been described. The purpose of this study was to evaluate suture cerclage fixation of the humeral shaft during shoulder arthroplasty. Materials and methods Shoulder arthroplasty cases performed from 2012-2017 by 3 fellowship-trained shoulder arthroplasty surgeons were reviewed. Cases in which suture cerclage was used for osteotomy, fracture, or allograft fixation were identified. Demographic data, indications, implant types, fixation techniques, and complications were reviewed. Postoperative radiographs were analyzed for union, component loosening, and loss of fixation. American Shoulder and Elbow Surgeons and Single Assessment Numeric Evaluation scores were collected preoperatively and postoperatively. Results A total of 27 patients (3 primary and 24 revision cases) with a mean age of 69.6 years (range, 28-88 years) were available for follow-up at a mean of 12.6 months (range, 0.8-42.3 months) postoperatively. Humeral osteotomy alone was performed in 15 cases. Allograft alone was used in 1 case. Both allograft and osteotomy were used in 6 cases. Complications occurred in 3 patients (11%), comprising 1 postoperative periprosthetic fracture and 2 prosthetic joint infections; all required further surgery. Radiographs at final follow-up showed healing of all osteotomies and fractures. No hardware failure or implant loosening occurred. The mean postoperative American Shoulder and Elbow Surgeons and Single Assessment Numeric Evaluation scores were significantly improved (α = .05) compared with preoperative scores, from 21.4 to 44.5 ( P = .002) and from 26.7 to 74.1 ( P < .001), respectively. Conclusion Suture cerclage is safe and effective for humeral fixation in shoulder arthroplasty.

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Section: Discussionmentioning

confidence: 53%

Suture cerclage for stabilizing the humeral shaft during shoulder arthroplasty

Eyberg¹,

Walker²,

Harmsen³

et al. 2020

JSES International

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“…To determine the clinical relevance of ASES scores, the minimal clinically important difference (MCID), the substantial clinical benefit (SCB), and the patient acceptable symptomatic state (PASS) were used. 16,20 The MCID and SCB were used to quantify the clinical significance of a change in scores on an outcome measure. 20 The PASS was used as a threshold score associated with patient satisfaction.…”

Section: Clinical Outcome Measuresmentioning

confidence: 99%

“…20 The MCID and SCB have been developed in shoulder arthroplasty and rotator cuff tear populations. 8,16 The SCB of the ASES score for TSA was a 20.7-point change, the PASS was an 81.9-point change, and the MCID was a 9.1-point change. 16…”

Section: Clinical Outcome Measuresmentioning

confidence: 99%

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Surgeon and Patient Upper Extremity Dominance Does Not Influence Clinical Outcomes After Total Shoulder Arthroplasty

Berthold

Muench

Kia

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Surgeon- and patient-specific characteristics as they pertain to total shoulder arthroplasty (TSA) are limited in the literature. The influence of surgeon upper extremity dominance in TSA and whether outcomes vary among patients undergoing right or left TSA with respect to surgeon handedness have yet to be investigated. Purpose: To determine whether surgeon or patient upper extremity dominance has an effect on clinical outcomes after primary TSA at short-term follow-up. Study Design: Case series; Level of evidence, 4. Methods: A retrospective chart review was performed on prospectively collected data from an institutional shoulder registry. Patients who underwent primary TSA for glenohumeral osteoarthritis from June 2008 to August 2012 were included in the study. Preoperative and postoperative American Shoulder and Elbow Surgeons (ASES), Simple Shoulder Test (SST), and visual analog scale (VAS) pain scores were evaluated. To determine the clinical relevance of ASES scores, the minimal clinically important difference (MCID), the substantial clinical benefit (SCB), and the patient acceptable symptom state (PASS) were used. Active forward elevation, abduction, and external rotation were recorded for each patient. Glenoid version was also evaluated preoperatively on standard radiographs. Results: Included in this study were 40 patients (n = 44 shoulders; mean age, 69.0 ± 7.3 years) with a mean follow-up of 36.5 ± 16.2 months. Final active range of motion between patients who underwent dominant versus nondominant and left versus right TSA by a right-handed surgeon was not significantly different. Clinical outcomes including the ASES, SST, and VAS pain scores were compared, and no statistical significance was identified between groups. With regard to the ASES score, 89% of patients achieved the MCID, 64% achieved the SCB, and 60% reached or exceeded the PASS. No significant difference in preoperative glenoid version between groups could be found. Conclusion: With the numbers available, neither patient nor surgeon upper extremity dominance had a significant influence on clinical outcomes after primary TSA at short-term follow-up. Clinical Relevance: The influence of surgeon and patient upper extremity dominance on TSA outcomes is an important consideration, given the preferential use of the dominant extremity exhibited by most patients during activities of daily living. To this, operating on a right shoulder might be technically more demanding for a right-handed surgeon and vice versa, as it is considered in other subspecialties.

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“…In allen drei Scores bewerten die Patienten in einer einzelnen Frage den aktuellen Krankheitswert ihrer Schulter; der SANE lässt sich jedoch auch auf andere Gelenke anwenden. Insbesondere für den SANE konnte eine gute Korrelation mit anderen Schulter-PROMs nachgewiesen werden [19,39].…”

Section: Single Question Subjective Measuresunclassified

„Patient-reported outcome measures“ (PROMs) in der Schulter- und Ellenbogenchirurgie

2020

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Zusammenfassung„Patient-reported outcome measures“ (PROMs) sind Instrumente, mit denen der subjektive Gesundheitszustand eines Patienten gemessen werden kann. Sie gewinnen zunehmend an wissenschaftlicher, klinischer und gesundheitsökonomischer Bedeutung. Man unterscheidet zwischen generischen, gelenkspezifischen und krankheitsspezifischen PROMs. Um das Risiko von Verzerrungen oder erhöhter Variabilität zu vermeiden, müssen geeignete Übersetzungen mit transkulturellen Anpassungen und anschließender Validierung gemäß definierten Richtlinien durchgeführt werden. Für viele gängige Schulter- und Ellenbogenwerte existiert bis dato noch keine validierte Übersetzung. Die weltweit am häufigsten verwendeten Schulter-PROMs sind der Constant-Murley Score, der American Shoulder and Elbow Surgeons Shoulder Form und der Simple Shoulder Test. Studien zu Ellenbogenpathologien verwenden am häufigsten den Mayo Elbow Performance Score und den Disabilities of the Arm, Shoulder and Hand Score. Derzeit besteht jedoch kein wissenschaftlicher Konsens über die Verwendung von Schulter- und Ellenbogen-PROMs.

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Single Assessment Numeric Evaluation (SANE) is a reliable metric to measure clinically significant improvements following shoulder arthroplasty

Cited by 99 publications

References 31 publications

Suture cerclage for stabilizing the humeral shaft during shoulder arthroplasty

Suture cerclage for stabilizing the humeral shaft during shoulder arthroplasty

Surgeon and Patient Upper Extremity Dominance Does Not Influence Clinical Outcomes After Total Shoulder Arthroplasty

„Patient-reported outcome measures“ (PROMs) in der Schulter- und Ellenbogenchirurgie

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