PMID- 38164674 OWN - NLM STAT- MEDLINE DCOM- 20240103 LR - 20240213 IS - 1552-3365 (Electronic) IS - 0363-5465 (Linking) VI - 52 IP - 1 DP - 2024 Jan TI - Effect of Patient Characteristics on the Minimal Clinically Important Difference and Patient Acceptable Symptom State Thresholds After Arthroscopic Bankart Repair. PG - 174-180 LID - 10.1177/03635465231212652 [doi] AB - BACKGROUND: There is scarce literature on clinically significant values after arthroscopic Bankart repair (ABR). PURPOSE: To determine the minimal clinically important difference (MCID) and the patient acceptable symptom state (PASS) thresholds at 1 year for the Rowe and Athletic Shoulder Outcome Scoring System (ASOSS) scores after ABR and to determine the effect of patient characteristics on these metrics after ABR. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A retrospective review of patients undergoing ABR from a single institution between January 2017 and January 2020 was performed. Patients with at least 1 episode of instability and a minimum follow-up of 12 months were included. The exclusion criteria were as follows: bony defects of >20% on the anteroinferior portion of the glenoid based on a preoperative computed tomography scan; engaging Hill-Sachs lesions at 90 degrees of abduction and 90 degrees of external rotation based on an arthroscopic examination; previous surgery on the same shoulder; multidirectional instability or concomitant repair of full-thickness rotator cuff tears; superior labral anterior to posterior lesions; posterior labral tears; or humeral avulsion of the glenohumeral ligament lesions. Patient-reported outcome measures were collected both preoperatively and 1-year postoperatively. Delta was defined as the change between preoperative and 1-year postoperative scores. Distribution-based (one-half the standard deviation of the difference between pre- and postoperative outcome scores) and anchored-based approaches (response to a satisfaction question at 1 year) were used to estimate the MCID and the PASS, respectively. The optimal cutoff point, where sensitivity and specificity were maximized, and the percentage of patients achieving those thresholds were also calculated. RESULTS: Overall, 190 patients were included. The distribution-based MCID for the Rowe and ASOSS scores were calculated to be 8.2 and 8.7, respectively. The rate of patients who achieved MCID thresholds was 96% for the Rowe and 96% for ASOSS scores. The PASS threshold for the Rowe and ASOSS scores were >/=80 and >/=90, respectively. The rate of patients who achieved PASS scores after ABR were 86% and 83%, respectively. The MCID and PASS values showed great variability based on sex (men: 8.5 and >/=85 for Rowe / 8.9 and >/=90 for ASOSS, respectively, vs women: 6.7 and >/=73 for Rowe / 8.1 and >/=75 for ASOSS), age (>/=21: 8.4 and >/=80 / 9.2 and >/=90 vs <21: 7.8 and >/=75 / 7.7 and >/=85), sports participation (sports: 8.8 and >/=85 / 9.5 and >/=90 vs no sports: 8.1 and >/=75 / 8.6 and >/=80), and type of athlete (competitive: 8.4 and >/=85 / 8.9 and >/=87 vs recreational: 7.5 and >/=73 / 8.1 and >/=68). CONCLUSION: This study identified the MCID and PASS thresholds for the Rowe and ASOSS scores at 1 year after ABR. However, these values showed great variability when accounting for different patient characteristics such as sex, age, sports participation, and type of athlete, highlighting the importance of considering individual patient-specific characteristics for optimal treatment decision-making and ensuring treatment success tailored to each patient's unique needs and expectations. FAU - Pasqualini, Ignacio AU - Pasqualini I AD - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Tanoira, Ignacio AU - Tanoira I AD - Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. FAU - Hurley, Eoghan T AU - Hurley ET AD - Department of Orthopedic Surgery, Division of Hand and Upper Extremity, Duke University, Durham, North Carolina, USA. FAU - Ranalletta, Maximiliano AU - Ranalletta M AD - Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. FAU - Andres Rossi, Luciano AU - Andres Rossi L AD - Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. LA - eng PT - Journal Article PL - United States TA - Am J Sports Med JT - The American journal of sports medicine JID - 7609541 SB - IM MH - Male MH - Humans MH - Female MH - Minimal Clinically Important Difference MH - Arthroscopy/methods MH - *Shoulder Joint/diagnostic imaging/surgery MH - Arthroplasty MH - Retrospective Studies MH - Treatment Outcome MH - *Joint Instability/diagnostic imaging/surgery/complications MH - *Shoulder Dislocation/surgery OTO - NOTNLM OT - arthroscopic Bankart repair OT - minimal clinically important difference OT - patient acceptable symptom state OT - satisfaction OT - shoulder instability COIS- The authors declared that they have no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. EDAT- 2024/01/02 11:46 MHDA- 2024/01/03 09:43 CRDT- 2024/01/02 04:13 PHST- 2024/01/03 09:43 [medline] PHST- 2024/01/02 11:46 [pubmed] PHST- 2024/01/02 04:13 [entrez] AID - 10.1177/03635465231212652 [doi] PST - ppublish SO - Am J Sports Med. 2024 Jan;52(1):174-180. doi: 10.1177/03635465231212652.