Background:

Patient Acceptable Symptom State (PASS), minimal clinically important difference (MCID), and substantial clinical benefit (SCB) have rarely been assessed after arthroscopic superior capsular reconstruction (ASCR) with fascia lata autograft.

Purpose:

(1) To investigate PASS, MCID, and SCB values for pain visual analog scale (pVAS), American Shoulder and Elbow Surgeons (ASES) score, Constant score, and Single Assessment Numeric Evaluation (SANE) after ASCR with fascia lata autograft, (2) to investigate factors for achieving PASS, MCID, and SCB.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

We retrospectively collected data from patients who underwent ASCR between June 2013 and October 2020. A total of 88 patients were included, and anchor questions for deriving PASS, MCID, and SCB values were applied at a minimum 1-year follow-up postoperatively. PASS, MCID, and SCB were derived using sensitivity- and specificity-based approaches. Univariable and multivariable logistic regression analyses were performed to determine factors for achieving PASS, MCID, and SCB.

Results:

Based on receiver operating characteristic curves, all 4 scores had acceptable area under the curve values (>0.7) for PASS, MCID, and SCB values. The PASS, MCID, and SCB values were 1.5, 2.5, and 4.5 for pVAS; 81.0, 19.0, and 27.5 for the ASES score; 60.5, −0.5, and 5.5 for the Constant score; and 75.0, 27.5, and 32.5 for SANE, respectively. Poor preoperative scores were related to significantly higher odds ratios (ORs) for achieving MCID and SCB. Wide acromiohumeral distance and dominant side were related to higher ORs for achieving PASS for the ASES score, and subscapularis tear was related to lower ORs for achieving PASS for pVAS and SCB for the Constant score.

Conclusion:

Reliable PASS, MCID, and SCB values were achieved for at least 1 year after ASCR surgery. Poor preoperative score, wide acromiohumeral distance, and dominant side all demonstrated higher ORs for at least one value, but a subscapularis tear demonstrated lower ORs for achieving PASS for pVAS and SCB for the Constant score.

中文翻译：

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关节镜上包膜重建术后患者可接受的症状状态、最小的临床重要差异和显着的临床益处

背景：

在使用自体阔筋膜移植的关节镜上囊重建 (ASCR) 后，很少评估患者可接受的症状状态 (PASS)、最小的临床重要差异 (MCID) 和显着的临床益处 (SCB)。

目的：

(1) 调查自体阔筋膜 ASCR 后疼痛视觉模拟量表 (pVAS)、美国肩肘外科医生 (ASES) 评分、恒定评分和单次评估数值评估 (SANE) 的 PASS、MCID 和 SCB 值，( 2）调查实现PASS、MCID和SCB的因素。

学习规划：

队列研究（诊断）；证据水平，2。

方法：

我们回顾性收集了 2013 年 6 月至 2020 年 10 月期间接受 ASCR 的患者的数据。共纳入 88 名患者，并在术后至少 1 年的随访中应用了用于推导 PASS、MCID 和 SCB 值的锚定问题。PASS、MCID 和 SCB 是使用基于敏感性和特异性的方法得出的。进行单变量和多变量逻辑回归分析以确定实现 PASS、MCID 和 SCB 的因素。

结果：

根据接受者操作特征曲线，所有 4 个分数的 PASS、MCID 和 SCB 值的曲线下面积 (>0.7) 均可接受。pVAS 的 PASS、MCID 和 SCB 值为 1.5、2.5 和 4.5；ASES 分数分别为 81.0、19.0 和 27.5；60.5、-0.5 和 5.5 的常数分数；SANE 分别为 75.0、27.5 和 32.5。较差的术前评分与显着较高的获得 MCID 和 SCB 的优势比 (OR) 有关。宽肩肱距离和优势侧与较高的 ORs 相关，以实现 ASES 评分的 PASS，肩胛下肌撕裂与较低的 ORs 相关，以实现 pVAS 和 SCB 的 Constant 评分。

结论：

在 ASCR 手术后至少 1 年达到可靠的 PASS、MCID 和 SCB 值。较差的术前评分、较宽的肩肱距离和优势侧都显示出至少一个值的较高 OR，但肩胛下肌撕裂显示 pVAS 达到 PASS 和恒定评分 SCB 的 OR 较低。