PMID- 34808350
OWN - NLM
STAT- MEDLINE
DCOM- 20220425
LR  - 20220425
IS  - 1532-6500 (Electronic)
IS  - 1058-2746 (Linking)
VI  - 31
IP  - 5
DP  - 2022 May
TI  - Characterization of ASES score pain and functional improvement after anatomic 
      total shoulder arthroplasty: a patient-centered perspective.
PG  - 1042-1046
LID - S1058-2746(21)00810-7 [pii]
LID - 10.1016/j.jse.2021.10.031 [doi]
AB  - BACKGROUND: Interpretation of anchor-based clinical differences in the context of 
      pain and functional change remains undefined. The purpose of this study was to 
      characterize American Shoulder and Elbow Surgeons Standardized Shoulder 
      Assessment Form (ASES) scores for patients after anatomic total shoulder 
      arthroplasty with minimum 1 year of follow-up in terms of pain and change in each 
      functional element on the ASES. METHODS: We performed a retrospective study of a 
      prospective institutional patient database of primary anatomic total shoulder 
      arthroplasties from 2017-2020 with baseline and 1-year postoperative ASES scores. 
      Three clinical outcome groups were established using an anchor-based global 
      rating of change assessment: minimal clinically important difference (MCID), 
      moderate clinical benefit (MCB), and substantial clinical benefit (SCB). Pain and 
      functional outcomes in each group where then characterized and compared. RESULTS: 
      A total of 67 patients were analyzed in terms of demographics and clinical 
      outcomes. Two-thirds (65%) of patients achieved the SCB, 24% achieved the MCB, 
      and 10% achieved the MCID. Washing, reaching for a shelf, and throwing were the 
      most common functional deficits experienced preoperatively and accounted for the 
      largest improvement in function postoperatively. Patients in the MCID group had 
      higher preoperative visual analog scale (VAS) pain scores (7.1 +/- 3.0) than the 
      MCB (5.8 +/- 2.5) or SCB (5.8 +/- 2.2) groups (P = .0612). The MCID group had the 
      least amount of preoperative functional deficits when compared to the MCB and SCB 
      groups (P = .041). Postoperative VAS pain scores improved by 5.1 in the SCB, 3.6 
      in the MCB, and 3.7 in the MCID groups. Functional change in each element of the 
      ASES improved by 1.4/4 in the SCB, followed by 0.9/4 in the MCB group and 0.05/4 
      in the MCID group (P < .001). CONCLUSION: The MCID group had higher preoperative 
      pain scores and the least amount of preoperative functional deficits when 
      compared to the MCB and SCB groups. The MCID was realized through pain 
      improvement only, whereas the MCB and SCB consisted of meaningful improvements in 
      pain and function.
CI  - Published by Elsevier Inc.
FAU - Ahmed, Rifat
AU  - Ahmed R
AD  - Department of Orthopedic Surgery, Division of Shoulder Elbow and Sports Medicine 
      (SESM), Columbia University Medical Center, New York, NY, USA.
FAU - Lanham, Nathan S
AU  - Lanham NS
AD  - Department of Orthopedic Surgery, Division of Shoulder Elbow and Sports Medicine 
      (SESM), Columbia University Medical Center, New York, NY, USA. Electronic 
      address: nathanscottlanham@gmail.com.
FAU - Peterson, Joel R
AU  - Peterson JR
AD  - Department of Orthopedic Surgery, Division of Shoulder Elbow and Sports Medicine 
      (SESM), Columbia University Medical Center, New York, NY, USA.
FAU - Jobin, Charles M
AU  - Jobin CM
AD  - Department of Orthopedic Surgery, Division of Shoulder Elbow and Sports Medicine 
      (SESM), Columbia University Medical Center, New York, NY, USA.
FAU - Levine, William N
AU  - Levine WN
AD  - Department of Orthopedic Surgery, Division of Shoulder Elbow and Sports Medicine 
      (SESM), Columbia University Medical Center, New York, NY, USA.
LA  - eng
PT  - Journal Article
DEP - 20211119
PL  - United States
TA  - J Shoulder Elbow Surg
JT  - Journal of shoulder and elbow surgery
JID - 9206499
SB  - IM
MH  - *Arthroplasty, Replacement, Shoulder
MH  - Humans
MH  - Pain
MH  - Patient-Centered Care
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - *Shoulder Joint/surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - MCB
OT  - MCID
OT  - SCB
OT  - anatomic total shoulder arthroplasty
OT  - shared decision making
EDAT- 2021/11/23 06:00
MHDA- 2022/04/26 06:00
CRDT- 2021/11/22 20:17
PHST- 2021/07/25 00:00 [received]
PHST- 2021/10/18 00:00 [revised]
PHST- 2021/10/23 00:00 [accepted]
PHST- 2021/11/23 06:00 [pubmed]
PHST- 2022/04/26 06:00 [medline]
PHST- 2021/11/22 20:17 [entrez]
AID - S1058-2746(21)00810-7 [pii]
AID - 10.1016/j.jse.2021.10.031 [doi]
PST - ppublish
SO  - J Shoulder Elbow Surg. 2022 May;31(5):1042-1046. doi: 10.1016/j.jse.2021.10.031. 
      Epub 2021 Nov 19.