Purpose
To determine the minimal clinically important differences (MCIDs) for the Rowe score
and the American Shoulder and Elbow Surgeons (ASES) score after arthroscopic stabilization
surgery for anterior shoulder instability and to evaluate the effect of various patient-
and treatment-related factors on MCIDs.
Methods
The study enrolled 216 patients who underwent arthroscopic stabilization surgery for
anterior shoulder instability. The patients were categorized into “no-change” and
“minimal-change” groups by a 15-item questionnaire at the 1-year postoperative visit.
The Rowe and ASES scores were assessed preoperatively and at the 1-year postoperative
follow-up visit. MCIDs were calculated using an anchor-based method. Correlations
between MCIDs and several factors were evaluated using Spearman correlation analysis
and univariate regression analysis.
Results
On the basis of the questionnaires administered at the 1-year postoperative follow-up
visit, 10 patients were assigned to the no-change group and 33 patients were placed
in the minimal-change group. MCIDs for the Rowe and ASES scores were 9.7 and 8.5,
respectively. Body mass index was negatively correlated with the MCID for the Rowe
score (P = .01). Number of dislocations, symptom duration, and presence of Hill-Sachs lesions
were positively correlated with the MCID for the ASES score (P = .02, P = .04, and P = .02, respectively). Other variables such as age, sex, and arm dominance were not
related to the MCIDs for either the Rowe or ASES score.
Conclusions
In patients who underwent arthroscopic stabilization surgery, differences of at least
9.7 in the Rowe score and 8.5 in the ASES score were clinically relevant. Patients
with a greater body mass index required a smaller change in the Rowe score and patients
with a greater number of dislocations, a longer symptom duration, or a Hill-Sachs
lesion required a larger change in the ASES score to feel clinically relevant changes.
Level of Evidence
Level IV, case series.
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Article info
Publication history
Accepted:
August 2,
2018
Received:
April 16,
2018
Footnotes
The authors report the following potential conflict of interest or source of funding: This work was supported by a National Research Foundation of Korea grant funded by the Korea government (NRF-2016R1D1A1A09919541). Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
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© 2019 by the Arthroscopy Association of North America
