Determination of Threshold Scores for Treatment Success After Arthroscopic Rotator Cuff Repair Using Oxford, Constant, and University of California, Los Angeles Shoulder Scores

Abstract

To determine the threshold scores for the Constant-Murley score (CMS); University of California, Los Angeles (UCLA) shoulder score; and Oxford Shoulder Score (OSS) that determine treatment success after arthroscopic rotator cuff(RC) repair. Patients who underwent unilateral arthroscopic double-row RC repair by a single surgeon between 2010 and 2015 were prospectively followed up and assessed preoperatively and at 6, 12, and 24months postoperatively. Perceived pain was measured with a visual analog scale, and functional outcome was assessed by the CMS, UCLA score, and OSS. Treatment success was defined as simultaneous fulfillment of 3 criteria: improvement in pain, expectations for surgery met, and patient satisfied with surgery. Threshold scores were determined by receiver operating characteristic (ROC) analyses, using the various scores as predictors and the defined treatment success as the criterion. The study included a total of 214 patients (96 male and 118 female patients) with a mean age of 60.1 ± 10years. Most patients showed improvement in pain (≥88%) and high satisfaction (≥93%) and expectation fulfillment (≥80%) postoperatively. Of the patients, 73% had treatment success at 6months; 85%, at 12months; and 80%, at 24months. ROC analyses showed good prediction of treatment success using the CMS, UCLA score, and OSS at all 3 follow-up time points (area under the ROC curve [AUC] > 0.70), with excellent prediction using the UCLA score at 12months and 24months (AUC, 0.811 and 0.805, respectively) and the OSS at 12months (AUC, 0.820). The following threshold scores were identified: CMS of 59, UCLA score of 21, and OSS of 42 at 6months; CMS of 61, UCLA score of 26, and OSS of 43 at 12months; and CMS of 65, UCLA score of 30, and OSS of 46 at 24months. The CMS, UCLA score, and OSS have good predictive value in defining treatment success after arthroscopic RC repair. The cutoff scores are time dependent. Level II, development of diagnostic criteria.