PMID- 38164689 OWN - NLM STAT- MEDLINE DCOM- 20240103 LR - 20240213 IS - 1552-3365 (Electronic) IS - 0363-5465 (Linking) VI - 52 IP - 1 DP - 2024 Jan TI - Establishing the Minimal Clinically Important Difference, Substantial Clinical Benefit, and Patient Acceptable Symptomatic State After Arthroscopic Posterior Labral Repair for Posterior Glenohumeral Instability. PG - 207-214 LID - 10.1177/03635465231210289 [doi] AB - BACKGROUND: Posterior glenohumeral instability is an increasingly recognized cause of shoulder pain and dysfunction among young, active populations. Outcomes after posterior stabilization procedures are commonly assessed using patient-reported outcome measures including the Single Assessment Numeric Evaluation (SANE), the Rowe instability score, the American Shoulder and Elbow Surgeons (ASES) score, and the visual analog scale (VAS) for pain. The clinical significance thresholds for these measures after arthroscopic posterior labral repair (aPLR), however, remain undefined. PURPOSE: We aimed to define the minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptomatic state (PASS) for the SANE, Rowe score, and ASES score as well as the VAS pain after aPLR. Additionally, we sought to determine preoperative factors predictive of reaching, as well as failing to reach, clinical significance. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: This study was a retrospective analysis of patient-reported outcome scores collected from patients who underwent aPLR between January 2011 and December 2018. To determine the clinically significant threshold that corresponded to achieving a meaningful outcome, the MCID, SCB, and PASS were calculated for the SANE, Rowe score, ASES score, and VAS pain utilizing either an anchor- or distribution-based method. Additionally, univariate and multivariate logistic regression analyses were performed to determine the factors associated with achieving, or not achieving, the MCID, SCB, and PASS. RESULTS: A total of 73 patients with a mean follow-up of 82.55 +/- 24.20 months were available for final analysis. MCID, SCB, and PASS values for the VAS pain were 1.10, 6, and 3, respectively; for the ASES score were 7.8, 34, and 80, respectively; for the SANE were 10.15, 33, and 85, respectively; and for the Rowe score were 11.3, 60, and 90, respectively. To meet the MCID, male sex (odds ratio [OR], 1.1639; P = .0293) was found to be a positive predictor for the VAS pain, and a lower preoperative SANE score (OR, 0.9939; P = .0003) was found to be a negative predictor for the SANE. Dominant arm involvement was associated with lower odds of achieving the PASS for the ASES score (OR, 0.7834; P = .0259) and VAS pain (OR, 0.7887; P = .0436). Patients who reported a history of shoulder trauma were more likely to reach the PASS for the SANE (OR, 1.3501; P = .0089), Rowe score (OR, 1.3938; P = .0052), and VAS pain (OR, 1.3507; P = .0104) as well as the SCB for the ASES score (OR, 1.2642; P = .0469) and SANE (OR, 1.2554; P = .0444). A higher preoperative VAS pain score was associated with higher odds of achieving the SCB for both the VAS pain (OR, 1.1653; P = .0110) and Rowe score (OR, 1.1282; P = .0175). Lastly, concomitant biceps tenodesis was associated with greater odds of achieving the SCB for the ASES score (OR, 1.3490; P = .0130) and reaching the PASS for the SANE (OR, 1.3825; P = .0038) and Rowe score (OR, 1.4040; P = .0035). CONCLUSION: To our knowledge, this study is the first to define the MCID, SCB, and PASS for the ASES score, Rowe score, SANE, and VAS pain in patients undergoing aPLR. Furthermore, we found that patients who reported a history of shoulder trauma and those who underwent concomitant biceps tenodesis demonstrated a greater likelihood of achieving clinical significance. Dominant arm involvement was associated with lower odds of achieving clinical significance. FAU - Scanaliato, John P AU - Scanaliato JP AD - Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA. FAU - Green, Clare K AU - Green CK AD - George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA. FAU - Sandler, Alexis B AU - Sandler AB AD - William Beaumont Army Medical Center, Fort Bliss, Texas, USA. FAU - Hurley, Eoghan T AU - Hurley ET AUID- ORCID: 0000-0002-7696-2981 AD - Duke University, Durham, North Carolina, USA. FAU - Hettrich, Carolyn M AU - Hettrich CM AD - Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA. FAU - Parnes, Nata AU - Parnes N AD - Department of Orthopedics, Carthage Area Hospital, Carthage, New York, USA. AD - Claxton-Hepburn Medical Center, Ogdensburg, New York, USA. 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 - Humans MH - Male MH - Treatment Outcome MH - Retrospective Studies MH - *Minimal Clinically Important Difference MH - Case-Control Studies MH - *Shoulder Injuries/surgery MH - Shoulder Pain MH - Arthroscopy/methods OTO - NOTNLM OT - clinical significance OT - labral repair OT - posterior labral tear OT - posterior shoulder instability COIS- One or more of the authors has declared the following potential conflict of interest or source of funding: J.P.S. has received hospitality payments from Stryker. C.M.H. has received consulting fees from Miach and Ossia, has received a gift from Wright Medical Technology, and holds stock in Activas Orthopedics. N.P. has received consulting fees from DePuy Synthes. 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 11:45 MHDA- 2024/01/03 09:42 CRDT- 2024/01/02 04:13 PHST- 2024/01/03 09:42 [medline] PHST- 2024/01/02 11:45 [pubmed] PHST- 2024/01/02 04:13 [entrez] AID - 10.1177/03635465231210289 [doi] PST - ppublish SO - Am J Sports Med. 2024 Jan;52(1):207-214. doi: 10.1177/03635465231210289.