Determining the outcomes after shoulder surgery

Abstract

Measurement of the outcome following shoulder surgery often demonstrates the discrepancy between the surgeon's perceptions and those of the patient. Therefore, it has been recognized that it is no longer acceptable to present purely surgeon-reported outcomes for shoulder surgery. As the number of shoulder procedures performed worldwide has increased in recent years, so has the necessity to measure performance. A combination of patient-reported outcome measures (PROMs), surgeon-reported outcomes and, for arthroplasty, national registry data is now commonly presented to quantify any change following intervention for a symptomatic shoulder joint. However, as the shoulder is a complex entity itself, involving a number of joints and possible pathologies, it can be difficult to comprehend whether a certain measure is being used appropriately. The aim of this article is to highlight the most frequently used outcome scores, including PROMs and national shoulder registries, discussing what they aim to measure, their strengths, limitations, specificity to pathology or procedure and cautions for bias.