Abstract
We performed a prospective cohort study to investigate the comparability of subjective and objective assessment scores of shoulder function following surgery for rotator cuff pathology.
A consecutive series of 372 patients underwent surgery for rotator cuff disorders with post-operative follow up over 24 months. 248 patients only had subacromial decompression, whereas 124 patients had rotator cuff repair additionally (93 arthroscopic; 31 open). Assessments were made pre-operatively, and at 3, 6, 12, and 24 months post-operatively using the Disabilities of the Arm, Shoulder, and Hand (DASH) score; Oxford Shoulder Questionnaire (OSQ); and the Constant score, which was used as a reference. Standardisation calculations were performed to convert all scores into a 0 to 100 scale, with 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) at each time point. Pearson’s Correlation coefficient was used to analyse the changes with time post-operatively. The statistical tests were used for the individual surgery types as well as all surgeries collectively. The relationship between the DASH and the Constant score was strongly correlated in all types of surgery.
The relationship between the Oxford and Constant scores was similar, except in the open rotator cuff repair group. There was no statistical difference between the mean DASH and Constant scores for all interventions at any time point. A significant difference was seen between the mean Oxford and Constant scores for at least one time point in all but the open rotator cuff repair group.
We demonstrate that the DASH and Oxford scoring systems would be useful substitutes for the Constant score, eliminating the need for a trained investigator and specialist equipment required to perform the Constant score with the associated cost benefits.
Correspondence should be addressed to Editorial Secretary Mr ML Costa or Assistant Editorial Secretary Mr B.J. Ollivere at BOA, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England; Email: mattcosta@hotmail.com or ben@ollivere.co.uk
