PMID- 29162305
OWN - NLM
STAT- MEDLINE
DCOM- 20180716
LR  - 20181202
IS  - 1532-6500 (Electronic)
IS  - 1058-2746 (Linking)
VI  - 27
IP  - 2
DP  - 2018 Feb
TI  - Quantifying success after total shoulder arthroplasty: the minimal clinically 
      important difference.
PG  - 298-305
LID - S1058-2746(17)30592-X [pii]
LID - 10.1016/j.jse.2017.09.013 [doi]
AB  - BACKGROUND: Knowledge of the minimal clinically important difference (MCID) for 
      different shoulder outcome metrics and range of motion after total shoulder 
      arthroplasty (TSA) can be useful to establish a minimum threshold of improvement 
      that defines successful treatment. This study quantifies how MCID varies with 
      different prosthesis types, patient age, gender, and length of follow-up after 
      TSA. METHODS: A total of 466 anatomic TSA (aTSA) and reverse TSA (rTSA) with 
      2-year minimum follow-up were performed by 13 shoulder surgeons. The MCID for the 
      American Shoulder and Elbow Surgeons, Constant, University of California Los 
      Angeles Shoulder Rating Scale, Simple Shoulder Test, Shoulder Pain and Disability 
      Index, global shoulder function, and visual analog scale for pain scores, as well 
      as active abduction, forward flexion, and external rotation, were calculated for 
      different prosthesis types and patient cohorts using an anchor-based method. 
      RESULTS: The anchor-based MCID results were American Shoulder and Elbow 
      Surgeons = 13.6 +/- 2.3, Constant score = 5.7 +/- 1.9, University of California Los 
      Angeles Shoulder Rating Scale = 8.7 +/- 0.6, Simple Shoulder Test 
      score = 1.5 +/- 0.3, Shoulder Pain and Disability Index score = 20.6 +/- 2.6, global 
      shoulder function = 1.4 +/- 0.3, pain visual analog scale  = 1.6 +/- 0.3, active 
      abduction = 7 degrees  +/- 4 degrees , active forward flexion = 12 degrees  +/- 4 degrees , and active external 
      rotation = 3 degrees  +/- 2 degrees . Female gender and rTSA were associated with lower MCID values 
      compared with male gender and aTSA patients. CONCLUSION: The minimum improvement 
      necessary for patients to achieve a result they believe is clinically meaningful 
      after aTSA and rTSA is nominal and was achieved by at least 80% of the patients. 
      Future endeavors should investigate the influence of different anchor questions 
      on the MCID calculation.
CI  - Copyright (c) 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. 
      Published by Elsevier Inc. All rights reserved.
FAU - Simovitch, Ryan
AU  - Simovitch R
AD  - Palm Beach Orthopaedic Institute, Palm Beach Gardens, FL, USA.
FAU - Flurin, Pierre-Henri
AU  - Flurin PH
AD  - Department of Orthopedic Surgery, Bordeaux-Merignac Clinic, Merignac, France.
FAU - Wright, Thomas
AU  - Wright T
AD  - Department of Orthopedic Surgery, Department of Orthopedics, University of 
      Florida, Gainesville, FL, USA.
FAU - Zuckerman, Joseph D
AU  - Zuckerman JD
AD  - Department of Orthopedic Surgery, NYU Langone Orthopaedic Hospital, New York, NY, 
      USA. Electronic address: joseph.zuckerman@nyumc.org.
FAU - Roche, Christopher P
AU  - Roche CP
AD  - Exactech, Inc., Gainesville, FL, USA.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20171120
PL  - United States
TA  - J Shoulder Elbow Surg
JT  - Journal of shoulder and elbow surgery
JID - 9206499
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Arthroplasty, Replacement, Shoulder/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Minimal Clinically Important Difference
MH  - Pain, Postoperative/*diagnosis
MH  - Range of Motion, Articular
MH  - Shoulder Joint/diagnostic imaging/physiopathology/*surgery
MH  - Shoulder Pain/*diagnosis
MH  - Time Factors
MH  - Treatment Outcome
MH  - Visual Analog Scale
OTO - NOTNLM
OT  - MCID
OT  - Minimal clinically important difference
OT  - anatomic total shoulder arthroplasty
OT  - reverse total shoulder arthroplasty
OT  - shoulder arthroplasty
OT  - shoulder replacement
EDAT- 2017/11/23 06:00
MHDA- 2018/07/17 06:00
CRDT- 2017/11/23 06:00
PHST- 2017/07/19 00:00 [received]
PHST- 2017/08/28 00:00 [revised]
PHST- 2017/09/09 00:00 [accepted]
PHST- 2017/11/23 06:00 [pubmed]
PHST- 2018/07/17 06:00 [medline]
PHST- 2017/11/23 06:00 [entrez]
AID - S1058-2746(17)30592-X [pii]
AID - 10.1016/j.jse.2017.09.013 [doi]
PST - ppublish
SO  - J Shoulder Elbow Surg. 2018 Feb;27(2):298-305. doi: 10.1016/j.jse.2017.09.013. 
      Epub 2017 Nov 20.