University Of California, Los Angeles Scale Research Articles

Predictors of Early Return to Sport After Surgical Repair of Proximal Hamstring Complex Injuries in Professional Athletes: A Prospective Study

Background: Proximal hamstring complex injury (PHCI) is a common injury among professional athletes, particularly those participating in pivot contact sports. Previous studies have suggested that surgery can be effective in restoring function and allowing athletes to return to sport (RTS), but the factors influencing successful RTS have been less clear. Purpose: To assess RTS capabilities after surgical treatment of PHCI in professional athletes and to identify favorable predictors of RTS. Study Design: Case series; Level of evidence, 4. Methods: This study (2002-2022) was conducted on professional athletes who underwent surgical treatment for PHCI at a sports surgery center. The primary outcome of the study was the RTS capability, evaluated based on the rate of athletes’ return to their preinjury level of competition, time delay to RTS, and quality of RTS as measured using their level of performance and progression of scores on activity scales such as the Tegner Activity Scale (TAS) and University of California, Los Angeles (UCLA), scale. “Maintained performance” was defined as athletes returning to the same preinjury activity level (per the TAS and UCLA scale) and perceiving themselves to have maintained their performance. Secondary outcomes covered the potential RTS predictors and complication rate. The study distinguished 2 types of PHCI: proximal hamstring tendon avulsion injury (proximal rupture with empty footprint, or having a “positive dropped ice cream sign”) and complete proximal hamstring free tendon rupture (PHTR; proximal rupture without empty footprint, or having a “negative dropped ice cream sign”). Results: The study examined 64 professional athletes (mean age, 27.3 years; 82.8% male) undergoing surgery for PHCI. The RTS rate was 98.4%, with 78.1% of the athletes returning to their preinjury level of competition at 6.2 months (SD, 2.5 months). Twelve (19%) patients had returned to sport at an inferior level of competition, and 2 (3.1%) were unable to continue in their preinjury sport. Subgroup analysis revealed variation in RTS based on sport type, with the highest rate of return to preinjury performance found in athletes in handball and sports with splits (fencing, squash, and escalade; 100%) and soccer (95.2%). In the univariate analysis, male sex (hazard ratio [HR], 4.05; 95% CI, 1.45-11.3; P = .008), higher preinjury TAS score (HR, 1.27; 95% CI, 1.06-1.52; P = .011), injury involving the semimembranosus (HR, 4.84; 95% CI, 2.31-10.2; P < .001) or conjoint tendon (HR, 3.12; 95% CI, 1.55-6.25; P = .001), and PHTR (HR, 7.77; 95% CI, 3.54-17.0; P < .001) were significantly associated with a better postoperative level of competition. Multivariate analysis identified 3 favorable predictors of RTS with HRs of 2.91 (95% CI, 1.01-8.35; P = .047) for male sex, 3.86 (95% CI, 1.78-8.37; P < .001) for isolated semimembranosus injury, and 5.18 (95% CI, 2.24-12.0; P < .001) for PHTR. The complication rate was 4.7%. Conclusion: Favorable predictors of early RTS were male sex, isolated semimembranosus injury, and PHTR injuries. Registration: NCT02906865 (ClinicalTrials.gov identifier).

Evaluating measures to assess loneliness in autistic adults.

There has been increasing interest in research on loneliness in autistic adults. Much of this research has involved giving autistic adults widely-used questionnaires that are thought to measure how lonely people are. However, these questionnaires have been developed for the general public. We do not know whether these questionnaires accurately measure how lonely autistic adults are. We asked 203 autistic adults to complete an online survey that included two widely-used loneliness questionnaires: (1) the University of California, Los Angeles (UCLA) Loneliness Scale Version 3 and (2) the Social and Emotional Loneliness Scale for Adults (SELSA). We also asked participants to rate how lonely they were from 1 (often/always) to 5 (never). Participants were then asked to give their views on the questionnaires (e.g. what they thought was good, and what they thought was not so good about them). We found that the scores on the UCLA scale and the SELSA aligned with participants' ratings of how lonely they were, which suggests that these two questionnaires accurately measure loneliness in autistic people. However, our participants also identified several ways to improve the questionnaires. This included (1) better distinguishing the characteristics/experiences of loneliness from those of being autistic; (2) better reflecting how loneliness may change at different times and in different contexts and (3) making the phrasing of the questions clearer. Overall, our autistic participants tended to prefer the UCLA scale to the SELSA. Therefore, we present some recommendations about how the UCLA scale could be changed to be more suitable for autistic people.

Slackening of COVID-19 social isolation measures and resilience in young adults: a longitudinal study on medium-term effects on loneliness

Background Social isolation to contain the COVID-19 pandemic affected young adult mental health, partly through loneliness. Resilience is a protective factor for anxiety and depression after exposure to a stressor such as a pandemic. Medium-term effects of the COVID-19 pandemic on young adult mental health are yet to be defined. Aims This longitudinal study aimed to evaluate if slackening of social isolation reduced loneliness in young adult living in two European countries, and if this was positively related to their mental health care needs status. Methods A two-phase online survey was conducted from spring 2020 (T1) to summer 2020 (T2). The primary outcomes were the Resilience Scale for Adults (RSA) and the University of California Los Angeles (UCLA) Loneliness Scale. Participants reported mental health care needs before and during lockdown: professional help-seeking, psychotropic drugs use, and admission to a psychiatric department. Results There were 88 participants at T2 (retention rate 35%), of whom 78.4% were female, with a mean age of 22±2.4 years. They were grouped according to mental health care needs change. UCLA scale score decreased in 51 (58.0%) participants from T1 to T2. The group who experienced an increase in mental health care needs displayed a more significant decrease in the UCLA scale compared to the other groups (adjusted p=0.02 and 0.01). The difference of UCLA scale scores from T1 to T2 was positively correlated with the RSA score at T1 (p=0.02). Limitations This longitudinal design provides robust evidence, but the drop-off (attrition 65%) is a significant limitation. Our research was explorative and the results need to be confirmed in future studies. Conclusions Loneliness decreased in line with the slackening of social isolation. Resilience predicts the positive medium-term outcome of loneliness. Thus, interpersonal social support and resilience seem particularly beneficial for young adult mental health. Early assessment of resilience in large-scale disasters could represent a powerful tool for identifying at-risk subjects. Future research should focus on the long-term effects of the COVID-19 pandemic on young adult mental health.

Biceps tenotomy or tenodesis in association with rotator cuff repair: is there an influence on functional results? A retrospective cohort study.

Instability or tears of the long head of the biceps tendon (LHBT) may be present in more than 35% of rotator cuff repairs (RCR). To compare clinical results from patients undergoing arthroscopic RCR, according to the procedure performed at the LHBT. Retrospective cohort study designed at the shoulder and elbow clinic of Instituto de Ortopedia e Traumatologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Brazil. Functional results among patients were compared using the American Shoulder and Elbow Surgeons (ASES) and University of California Los Angeles (UCLA) scales, according to the LHBT approach adopted: no procedure, tenotomy or tenodesis. We evaluated 306 shoulders (289 patients): 133 underwent no procedure at the LHBT, 77 tenotomy and 96 tenodesis. The ASES scale at 24 months showed no difference (P = 0.566) between the groups without LHBT procedure (median 90.0; interquartile range, IQR 29), tenotomy (median 90.0; IQR 32.1) or tenodesis (median 94.4; IQR 22.7); nor did the UCLA scale (median 33; IQR 7 versus median 31; IQR 8 versus median 33; IQR 5, respectively, P = 0.054). The groups differed in the preoperative functional assessment according to the ASES and UCLA scale, such that the tenodesis group started from higher values. However, there was no difference in pre and postoperative scores between the groups. Tenodesis or tenotomy of the LHBT, in the sample analyzed, did not influence the clinical results from RCR, as assessed using the ASES and UCLA scales.

Translation, cross-cultural adaptation, reliability, and validity of Turkish version of the university of California Los Angeles (UCLA) shoulder scale into Turkish

Purpose To translate and culturally adapt the University of California Los Angeles (UCLA) shoulder scale into Turkish (T-UCLA) and determine its psychometric properties. Material and methods The UCLA scale was translated into Turkish using Beaton guidelines. Ninety-one patients (46 male; mean age: 46.0 ± 13.7 years) with shoulder disorders completed T-UCLA and American Shoulder and Elbow Score (ASES), Simple Shoulder Test (SST) and 36-Item Short Form (SF-36). Test–retest reliability was tested in 50 patients at a mean of 5.2 ± 2.2 days after initial assessment. Validity was evaluated in 91 patients, and correlations between ASES, SST and SF-36 were analyzed. Responsiveness was assessed in 33 patients who underwent arthroscopic rotator cuff repair with a mean follow-up of 12.8 ± 0.5 months. Results Test–retest reliability of overall T-UCLA, pain and function subscales were 0.96, 0.94 and 0.86, respectively. The correlation coefficients between T-UCLA and SST and ASES were r = 0.752 and r = 0.783, respectively (p < 0.001). The highest correlations between T-UCLA and SF-36 were observed in physical functioning (r = 0.64) and bodily pain subscales (r = 0.66). No ceiling or floor effect observed. Overall and subscales of T-UCLA were highly responsive (ES = 3.22–4.31). Conclusion T-UCLA has sufficient reliability and validity similar to original and translated versions. T-UCLA is responsive in patients who underwent rotator cuff repair. Implications for rehabilitation In this study, Turkish version of the UCLA was found to be a reliable and valid outcome measure in patients with various shoulder pathologies. Turkish version of the UCLA is a very responsive tool in patients with who underwent arthroscopic repair of rotator cuff tears.

A clinical study of shoulder arthroscopic rotator cuff repair on the psychological function of patients after operation.

Recently, psychological function in patients who underwent rotator cuff repair has been emphasized. However, the relationship of psychological function and clinical outcomes after rotator cuff repair is still poorly understood. This study aims to investigate the impact of arthroscopic rotator cuff repair on psychological status. Clinical data were collected retrospectively from 60 patients with rotator cuff tears treated at the First Affiliated Hospital of Soochow University from January 2013 to June 2016. Preoperative and postoperative parameters were calculated and analyzed, including the Visual Analog Scale (VAS) pain score, the University of California, Los Angeles Scale (UCLA), the American Shoulder and Elbow Surgeons scale (ASES), the Simple Shoulder Test (SST), and the Short Form 36 Health Survey (SF-36) scores. Compared with preoperative scores, the VAS score decreased significantly 1 year postoperatively (P<0.05). In contrast, the UCLA, ASES and SST scores improved significantly (P<0.05). The results of the Short Form 36 Physical Component Summary score (SF-36 PCS) and the Short Form 36 Mental Component Summary score (SF-36 MCS) were also improved, which had significant differences before and after arthroscopy surgery (P<0.05). Arthroscopic rotator cuff repair can significantly improve the psychological function of patients, promote their rapid recovery, and achieve satisfactory results.

Comparison of clinical outcomes between arthroscopic debridement and conservative treatment of primary adhesive capsulitis of the hip.

The purpose of this study was to assess the clinical outcomes and change of ROM between patients with adhesive capsulitis of the hip (ACH) who underwent arthroscopic treatment and those who underwent conservative treatment at a minimum follow-up of two years. From 2010 to 2017, 35 hips (32 patients, 10 men and 22 women) diagnosed with primary ACH were enrolled and followed up for a minimum of two years. Arthroscopic surgery was performed in 17 patients (20 hips, operation group), and conservative treatment was performed in 15 patients (15 hips, control group). Outcomes were measured with the visual analogue scale (VAS), University of California, Los Angeles (UCLA) activity scale, modified Harris hip score (mHHS), and degree of range of motion (ROM). The patients in the operation group were younger than those in the control group (mean age, 36.6 vs 46.2, p= 0.032). The VAS scores were significantly lower in the operation group than in the control group at twoweeks, sixweeks, and 24months of follow-up. Moreover, the operation group showed a trend of better values of UCLA and mHHS, with no statistical differences during the entire follow-up; these patients also achieved greater improvements of external rotation at sixweeks' evaluation. The patients with ACH in the two groups shows improvement of pain, UCLA scale, mHHS, and ROM at a minimum twoyear follow-up. Based on this study, we do not routinely recommend surgical treatment. However, patients with intractable pain and severe limitation of ROM are possible candidate of arthroscopic capsular release.

Factors lead to return to sports and recreational activity after total knee replacement - A retrospective study.

Introduction: The number of total knee replacements performed (TKR) is increasing and so are patient expectations and functional demands. The mean age at which orthopedic surgeons may indicate TKR is decreasing, and therefore return to sport (RTS) after TKR is often an important expectation for patients. The aim of this study was to analyze the mid-term RTS, recreational activities, satisfaction level, and forgotten joint level after TKR. Methods: Between January 2015 and December 2016, 536 TKR (same implant design, same technique) were performed in our center. The mean age at survey was 69 years with a mean follow-up of 43 months. All patients who did not have a follow-up in the last 6 months were called. Finally, 443 TKR were analyzed. RTS was assessed using the University of California Los Angeles Scale (UCLA), forgotten joint score (FJS), and Satisfaction Score. Results: In this study, 85% of patients had RTS after TKR with a mean UCLA score increasing from 4.48 to 5.92 and a high satisfaction rate. Satisfaction with activity level was 93% (satisfied and very satisfied patients). The RTS is more important for people with a higher preoperative UCLA score and a lower American Society of Anesthesiologist score (ASA). Each point increase in ASA score is associated with reduced probability to RTS by 52%. Discussion: RTS and recreational activity were likely after TKR with a high satisfaction score. Preoperative condition and activity are the two most significant predictive factors for RTS. Level of evidence: Retrospective case series, level IV.

Treatment of AC dislocation by reconstructing CC and AC ligaments with allogenic tendons compared with hook plates

BackgroundThe purpose of this study was to compare outcomes between allograft reconstruction and hook plate fixation for acute dislocation of the acromioclavicular joint with a minimum 2-year follow-up.MethodsA retrospective comparative study of patients treated for acute acromioclavicular joint dislocation from February 2010 to December 2014 in our hospital, consisting of 16 patients who were followed-up, was performed.Eight patients were treated for acute AC dislocation and underwent surgical reconstruction as follows: the coracoclavicular and acromioclavicular ligaments were reconstructed with the allogenic tendon. The other eight patients were treated with hook plates to maintain the AC joint reset. At the latest follow-up, radiographic analysis and the Constant and University of California-Los Angeles (UCLA) scores were used to evaluate shoulder function. The satisfaction of the patients in terms of the efficacy and visual analog scale (VAS) data were also recorded.ResultsAfter an average follow-up of 30.3 months (range 24–46 months), no patient had dislocated their joint again at the final follow-up based on X-ray examination. The Constant score was 94.4 for the allogenic tendon group and 93.8 for the hook plate group (P = 0.57). According to the UCLA scale (P = 0.23) or VAS (P = 0.16), we found no significant difference between the two groups. All patients reported that they were very satisfied or satisfied with the outcome of surgery, and no significant difference (P = 0.08) was found between the two groups.ConclusionsThe use of allogenic tendon for reconstruction of the coracoclavicular and acromioclavicular ligaments shows excellent outcomes in terms of the recovery of clinical function or radiographic outcomes for acute AC dislocation. Compared with the hook plate, the hardware did not need to be removed.

Use of grafts in rotator cuff re-rupture

Introduction and objectivesRotator cuff re-ruptures appear in 38–65% of cases. In order to reduce this rate, many studies have been performed using different types of biomaterial for purely mechanical aims (re-inforce the suture) and/or biological agents (growth factor transporterts). The aim of this study is to review 22 cases treated with xenografts and analyse various current alternatives. Materials and methodsA descriptive and retrospective study was conducted using the variables of age, sex, laterality, time of surgery, involvement in MRI, number of anchors, and final mobility results on the Constant and the University of California Los Angeles (UCLA) validated scales. ResultsThe study included 22 patients, with a mean age of 51.7±4.6 years. A mean of 2 anchors were used and 13 patients were treated with a porcine intestinal submucosa implant, 6 with equine pericardium, and 3 with porcine dermis. Final results were: 37.6±13 points for the Constant test, and 16.9±3.9 points on the UCLA scale. The follow up was 36±10.2 months. ConclusionsIn our experience, xenografts could provide good functional results and they would be a surgical alternative to tendon transfers in cases of massive tears. Further studies should be conducted with other biomaterials.

Utilización de injertos en la reparación de rerroturas del manguito rotador

Introduction and objectivesRotator cuff re-ruptures appear in 38-65% of cases. In order to reduce this rate, many studies have been performed using different types of biomaterial for purely mechanical aims (re-inforce the suture) and/or biological agents (growth factor transporterts). The aim of this study is to review 22 cases treated with xenografts and analyse various current alternatives. Materials and methodsA descriptive and retrospective study was conducted using the variables of age, sex, laterality, time of surgery, involvement in MRI, number of anchors, and final mobility results on the Constant and the University of California Los Angeles (UCLA) validated scales. ResultsThe study included 22 patients, with a mean age of 51.7±4.6 years. A mean of 2 anchors were used and 13 patients were treated with a porcine intestinal submucosa implant, 6 with equine pericardium, and 3 with porcine dermis. Final results were: 37.6±13 points for the Constant test, and 16.9±3.9 points on the UCLA scale. The follow up was 36±10.2 months. ConclusionsIn our experience, xenografts could provide good functional results and they would be a surgical alternative to tendon transfers in cases of massive tears. Further studies should be conducted with other biomaterials.

Sports and Activity Levels After Open Surgical Treatment of Femoroacetabular Impingement

Background: Several studies indicate that professional athletes can successfully return to competition after surgical treatment of femoroacetabular impingement (FAI). However, little is known about sports and activity levels after FAI surgery in the general patient population. Hypothesis/Purpose: The purpose was to determine the sports behavior, satisfaction with sports ability, and activity levels in a consecutive cohort of patients with FAI who were treated by surgical hip dislocation. The hypothesis was that the majority of patients (>75%) would be active in sports at follow-up. Study Design: Case series; Level of evidence, 4. Methods: This retrospective study included 153 patients (mean age, 30.0 years; 40.5% female) with 192 hips treated. Sports behavior and satisfaction were determined at a mean follow-up of 59.4 months with the use of a questionnaire. Activity levels at follow-up were assessed by the Hip Sports Activity Scale (HSAS) and the University of California, Los Angeles (UCLA) activity scale. Results: Of 126 patients who were regularly active in sports before surgery, 107 (85%) were so at follow-up. Nineteen patients (12.4%) stopped participating in regular sports, and 8 (5.2%) commenced with sports after the operation. The most popular activities before surgery were skiing (22%), cycling (22%), jogging (20%), and soccer (13%). At follow-up, most patients were engaged in cycling (23%), fitness/weight training (20%), skiing (18%), and jogging (11%). Of all patients, 75% were satisfied with their sports ability, and 25% were not. Moreover, 60.3% stated that their sports ability had improved after surgery, 20.5% declared no change, and 19.2% were subjectively deteriorated. The mean pain level during sports was rated to be 2.1 according to the visual analog scale. The mean HSAS score was 3.5 (range, 0-8), and the mean UCLA score was 7.7 (range, 3-10); male patients reported significantly higher scores than did female patients on the HSAS (4.1 vs 2.7, respectively) and UCLA scale (8.2 vs 7.0, respectively). Conclusion: The vast majority of patients with FAI who are treated by surgical hip dislocation return to sports activities, and most patients are satisfied with their sports ability at midterm follow-up. Activity levels are significantly higher in male patients, but this does not yield higher satisfaction rates.

The Benefit of Synthetic Versus Biological Patch Augmentation in the Repair of Posterosuperior Massive Rotator Cuff Tears

Background: Rotator cuff repair typically results in a satisfactory, although variable, clinical outcome. However, anatomic failure of the repaired tendon often occurs. Hypothesis: Patch augmentation can improve the results of open rotator cuff repair by supporting the healing process, protecting the suture, and reducing friction in the subacromial space. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 152 patients with a posterosuperior massive rotator cuff tear were treated by open repair only (control group; n = 51; mean age, 67.06 ± 4.42 years), open repair together with collagen patch augmentation (collagen group; n = 49; mean age, 66.53 ± 5.17 years), or open repair together with polypropylene patch augmentation (polypropylene group; n = 52; mean age, 66.17 ± 5.44 years) and were retrospectively studied. Patients were evaluated preoperatively and after 36 months with a visual analog scale (VAS) and the University of California, Los Angeles (UCLA) shoulder rating scale and by measuring elevation of the scapular plane and strength with a dynamometer. The VAS and UCLA scores were also obtained 2 months postoperatively. Tendon integrity was assessed after 1 year by ultrasound. Patients were homogeneous as per the preoperative assessment. Results: After 2 months, results (mean ± standard deviation) for the control, collagen, and polypropylene groups, respectively, were as follows: VAS scores were 6.96 ± 1.11, 6.46 ± 1.02, and 4.92 ± 0.90, while UCLA scores were 11.29 ± 1.46, 11.40 ± 1.51, and 19.15 ± 1.99. After 36 months, the mean scores for the respective groups were 3.66 ± 1.05, 4.06 ± 1.02, and 3.28 ± 1.10 for the VAS and 14.88 ± 1.98, 14.69 ± 1.99, and 24.61 ± 3.22 for the UCLA scale. In addition, after 36 months, elevation on the scapular plane was 140.68° ± 9.84°, 140.61° ± 12.48°, and 174.71° ± 8.18°, and abduction strength was 8.73 ± 0.54 kg, 9.03 ± 0.60 kg, and 13.79 ± 0.64 kg for the control, collagen, and polypropylene groups, respectively. The retear rate after 12 months was 41% (21/51) for the control group, 51% (25/49) for the collagen group, and 17% (9/52) for the polypropylene group. In particular, the reduced 12-month retear rate and the increased UCLA scores, abduction strength, and elevation at 3-year follow-up were statistically significant for patients treated with a polypropylene patch compared with those treated with repair only or with a collagen patch. Conclusion: Polypropylene patch augmentation of rotator cuff repair was demonstrated to significantly improve the 36-month outcome in terms of function, strength, and retear rate.

When Does the Quality of Life Improve after Rotator Cuff Repair?

Purpose: The purpose of this study was to investigate when the quality of life improve after rotator cuff repair. Materials and Methods: Eighty-five consecutive cases with rotator cuff repair were studied. Patients completed the visual analogue scale (VAS), University of California Los Angeles scale (UCLA), American Shoulder and Elbow Surgeon’s scale (ASES), Korean Shoulder scale (KSS), and the World Health Organization Quality of Life Scale abbreviated version (WHOQOL-BREF) preoperatively and at postoperative 3, 6, and 12 months. For evaluation of serial recovery pattern, section I (preoperatively-postoperative 3 months), section II (postoperative 3 months-postoperative 6 months), and section III (postoperative 6 months-postoperative 12 months) were divided. Results: The mean WHOQOL-BREF score was significantly improved from 58.8 preoperatively to 66.4 at postoperative 12 months, with improvement of VAS, ULCA, ASES, and KSS scores. On serial recovery pattern, all measurements in section I, VAS, UCLA, and KSS scores in section II, and UCLA score in section III, were significantly improved. Female sex had a negative effect on all outcome measurements at postoperative 12 months. Conclusion: Our results showed improvement of quality of life as well as reduced pain and increased function at 3 months after rotator cuff repair. Further recovery of clinical outcomes showed gradual progress until postoperative 12 months.

Surgical Hip Dislocation for the Treatment of Femoroacetabular Impingement in High-Level Athletes

Background: Midterm outcome studies show that symptomatic femoroacetabular impingement (FAI) can be successfully treated by addressing the underlying pathomorphology with open or arthroscopic surgery. Although athletes may be vulnerable to hip injury from impingement, limited information is available regarding the results of open surgery in this group. Hypothesis: High-level athletes with FAI can resume their sports after surgical hip dislocation and continue professional careers for a significant period. Study Design: Case series; Level of evidence, 4. Methods: Twenty-two professional male athletes (19.7 ± 2.2 years) were evaluated by postal survey at a mean of 45.1 months (range, 12 to 79) after treatment by surgical hip dislocation (30 hips, cam- or mixed-type FAI; mean α angle, 69.3°; 14 ice hockey players). Evaluation included types and level of sports, subjective ratings, and clinical outcomes: Hip Outcome Score, SF-12, UCLA (University of California, Los Angeles) activity scale, Hip Sports Activity Scale, visual analog scale for pain. The primary outcome variable was return to professional sports; the clinical result was the secondary outcome variable. Results: At follow-up, 21 of 22 patients (96%) were still competing professionally: 19 at their previous level and 2 in minor leagues. Eighteen (82%) were satisfied with their hip surgery and 19 (86%) with their sports ability. Mean activity levels were 9.8 per the UCLA scale and 7.6 per the Hip Sports Activity Scale. Mean scores of the Hip Outcome Score–Activities of Daily Living and Sport subscales were 94.5 and 89.1. Mean scores of the SF-12 physical and mental component summaries were 51.1 and 54.3. Pain levels during sports were 1.8 per the visual analog scale. Conclusion: Surgical hip dislocation for the treatment of FAI allows athletes to resume sports and continue professional careers at the same level for several years. Clinical outcomes in terms of subjective ratings and scores were favorable.

Which is the best activity rating scale for patients undergoing total joint arthroplasty?

We compared the metric properties of the University of California, Los Angeles (UCLA) activity scale, the Tegner score, and the Activity Rating Scale for assessment of activity levels in 105 patients undergoing THA (48 women; mean age, 63.4 years) and 100 patients undergoing TKA (61 women; mean age, 66.5 years). We assessed construct validity by correlating these scales with the International Physical Activity Questionnaire and different traditional patient self-reporting outcome measures. Test-retest reliability, feasibility, and floor and ceiling effects also were determined. The UCLA scale showed the strongest correlations with the other measures (r = -0.35 to 0.56 for THA; r = -0.55 to 0.23 for TKA) and was the only scale that discriminated between insufficiently and sufficiently active patients undergoing THA and TKA. The UCLA scale had the best reliability, provided the highest completion rate, and showed no floor effects. It seems to be the most appropriate scale for assessment of physical activity levels in patients undergoing total joint arthroplasty. Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.

Physical Therapy (97)

Comparison of the University of California (Los Angeles) shoulder scale and the simple shulder test with shoulder pain and disability index: Single‐administration reliability and validity. (Texas Woman's University, Houston, TX) Phys Ther. 2000;80:759–768.This study compared 2 shoulder measures—the University of California‐Los Angeles (UCLA) Shoulder Scale and the Simple Shoulder Test (SST)—with the Shoulder Pain and Disability Index (SPADI). One hundred ninety‐two patients with shoulder disorders were recruited from one physician's office to complete the self‐report sections of the 3 scales. Cronbach alpha values and standard errors of measurements (SEM) were calculated for each of the multi‐item subscales. Validity was examined through calculation of correlation coefficients among the 3 scales. Factor analysis was completed to assess the underlying constructs of the SPADI and SST. Cronbach alpha values ranged from 0.85 to 0.95. The SEM values for the multi‐item scales ranged from 4.75 to 11.65. Evidence for validity to reflect function was indicated by the correlation between the SST and the SPADI disability subscale. The factor analysis of the SPADI revealed loading on 1 factor, whereas the SST loaded on 2 factors. Conclude that all scales demonstrated good internal consistency, suggesting that all items for each scale measure the same constract. However, SEMS for all scales were high. Factor loading was consistent, suggesting that patients may not distinguish between pain and function. Comment by Philip S. Sizer Jr., MED, PT.Clinical practitioners are leaning toward evaluating functional status versus a pure‐impairment‐based approach to appraising shoulder limitations. Several scales have been developed for the evaluation of shoulder function, including the University of California Los Angeles Shoulder Scale (UCLA), the Simple Shoulder Test (SST), and the Shoulder Pain and Disability Index (SPADI). Investigations demonstrating the psychometric properties of these scales are limited in number. These investigators attempted to assess those properties, including internal consistency, reliability, and validity for all 3 scales. The analyses demonstrated internal consistency and construct homogeneity for the SPADI. However, all 3 scales demonstrated rather large standard errors of measure, which questions the reliability of the scales for measurement of an individual's progress. Regarding construct validity, the SPADI does not appear to distinguish between pain and dysfunction, disqualifying its use as a gold standard for comparison with other scales. While the SST purports to measure a single construct, the data suggests that it appears to measure 2 different constructs namely function and comfort. Additionally, the analyses appear to demonstrate that, while the scales may attempt to measure the same constructs, they apparently do not. Finally, the authors suggest that the precision of the UCLA scale is inferior to the other 2 scales and insufficient for following the progress of individual patients in the clinical setting.