OUTCOME OF SURGERY FOR ROTATOR CUFF DISORDERS: A COMPARISON OF SUBJECTIVE AND OBJECTIVE SCORING TOOLS

Abstract

To investigate the comparability of subjective and objective scores of shoulder function following surgery for rotator cuff pathology. From 2003 to 2006, 333 patients undergoing surgery for rotator cuff disorders were followed prospectively. 220 (66%) underwent solely subacromial decompression, whilst 113 (34%) had additional rotator cuff repair (92 arthroscopic; 21 mini-open). Assessments were made pre-operatively and six-monthly thereafter using the DASH score; Oxford Shoulder Questionnaire (OSQ); and Constant score, which was used as a reference. Standardisation calculations were used to convert all scores to a 0 to 100 scale (100 representing a normal shoulder). The student’s t test was used to compare the mean score for each subjective tool (DASH and OSQ) with the objective score (Constant). Correlation coefficients (Pearson’s) were used to analyse the post-operative course measured with subjective and objective tools for each intervention. Each statistical test was used for all surgeries collectively and the individual surgery types. There was no difference between the mean DASH and Constant scores. A significant difference was seen between the Oxford and Constant scores for at least one time point in each treatment group. Strong correlation was demonstrated between both subjective scores and the Constant. The mean Pearson correlation coefficient comparing the DASH and Constant was 0.96, whilst that for the Oxford and Constant was 0.89. The DASH and Constant scores provided identical results in terms of absolute values at a given time point, and with respect to rates of recovery. The relationship between the Oxford and Constant was less robust. In this study the DASH and Constant scores were indistinguishable, justifying the use of only the former for follow-up, obviating the need for a trained investigator required to perform a Constant score.