OPTIMAL CUT-OFF SCORES FOR DISEASE-SPECIFIC QUALITY OF LIFE TO DISCRIMINATE CLINICAL OUTCOMES IN PATIENTS WITH ARTHROSCOPIC ROTATOR CUFF REPAIR

Yıl 2024, Cilt: 5 Sayı: 2, 174 - 183, 30.06.2024

Caner Karartı , Hakkı Çağdaş Basat , İsmail Özsoy , Fatih Özyurt

Öz

Objective: Identifying a cut-off score would be useful in detecting improvements in disease-specific quality of life (DS-QoL) in patients with arthroscopic rotator cuff repair (ARCR). The aim of this study was to identify clear cut-off values for the Western Ontario Rotator Cuff Index (WORC) score. In addition, the ability of these cut-off scores to predict DS-QoL level was investigated.
Method: A total of 38 ARCR patients were included in this cross-sectional study. Patients were assessed using the Constant-Murley and WORC scores following 12 weeks of physiotherapy. Pearson correlation coefficients were used to analyse the relationship between these scores. The WORC cut-off scores representing excellent and good DS-QoL were calculated on the basis of the Constant score. The ability of the these cut-offs to predict the level of DS-QoL was examined using logistic regression analysis.
Results: The WORC cut-off scores of 87.5 and 79.5 were found to be excellent and good level of DS-QoL. Participants with WORC scores above these cut-offs have a 1.25 and 1.74 times higher level of DS-QoL, respectively.
Conclusion: The success of physiotherapy and ARCR could be assessed using the identified cut-off scores. It seems necessary to use more specific interventions for patients not meeting the WORC cut-off scores in order to improve DS-QoL.

Anahtar Kelimeler

Rotator Cuff, Tears, Shoulder Injuries, Orthopaedics

Artroskopik rotator manşet onarımı yapılan hastalarda klinik sonuçları ayırt etmek için hastalığa özgü yaşam kalitesine yönelik optimum kesme puanları

Öz

Amaç: Artroskopik rotator manşet onarımı (ARMO) yapılan hastalarda, hastalığa özgü yaşam kalitesindeki (HÖYK) iyileşmelerin tespit edilmesi için bir kesme puanının belirlenmesi yararlı olabilir. Bu çalışmanın amacı Western Ontario Rotator Cuff İndeksi (WORC) skoru için net kesme değerlerini belirlemekti. Ayrıca bu kesme puanlarının HÖYK düzeyini tahmin etme yeteneği araştırıldı.
Yöntem: Bu kesitsel çalışmaya ARMO uygulanan toplam 38 hasta dahil edildi. Hastalar 12 haftalık fizyoterapi sonrasında Constant-Murley ve WORC skorları kullanılarak değerlendirildi. Bu puanlar arasındaki ilişkinin analizinde Pearson korelasyon katsayıları kullanıldı. Mükemmel ve iyi HÖYK’ yi temsil eden WORC kesme puanları, Constant puanı temel alınarak hesaplandı. Bu kesme değerlerinin HÖYK düzeyini tahmin etme yeteneği, lojistik regresyon analizi kullanılarak incelenmiştir.
Bulgular: 87,5 ve 79,5’ luk WORC kesme puanlarının mükemmel ve iyi düzey HÖYK olduğu bulundu. WORC puanları bu kesme değerlerinin üzerinde olan katılımcıların HÖYK düzeyleri sırasıyla 1,25 ve 1,74 kat daha yüksektir.
Sonuç: Fizyoterapi ve ARMO' nun başarısı belirlenen kesme puanları kullanılarak değerlendirilebilir. HÖYK’ yi iyileştirmek için WORC kesme puanlarını karşılayamayan hastalara daha spesifik müdahalelerin kullanılması gerekli görünmektedir.

Anahtar Kelimeler

Rotator Manşet, Rüptür, Omuz Yaralanmaları, Ortopedi

Etik Beyan

This study was approved by Beykent University Human Research Ethics Committee (2022/203).

Kaynakça

• Angst, F., Schwyzer, H. K., Aeschlimann, A., Simmen, B. R., & Goldhahn, J. (2011). Measures of adult shoulder function: Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and its short version (QuickDASH), Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society standardized shoulder assessment form, Constant (Murley) Score (CS), Simple Shoulder Test (SST), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire (SDQ), and Western Ontario Shoulder Instability Index (WOSI). Arthritis Care Res (Hoboken), 63 Suppl 11, S174-188.
• Basat, H. Ç., Armangil, M., & Yoğun, Y. (2019). Effect of affective temperament on outcome of rotator cuff surgery. Orthopaedics & Traumatology: Surgery & Research, 105(8), 1549-1553.
• Constant, C., & Murley, A. (1987). A clinical method of functional assessment of the shoulder. Clinical orthopaedics and related research(214), 160-164.
• Demirhan, M., Akman, S., & Akalin, Y. (2004). Preoperative and postoperative scoring in the diseases of the shoulder joint. Acta Orthopaedica et Traumatologica Turcica, 27(2), 129-131.
• Doiron-Cadrin, P., Lafrance, S., Saulnier, M., Cournoyer, É., Roy, J. S., Dyer, J. O., Frémont, P., Dionne, C., MacDermid, J. C., Tousignant, M., Rochette, A., Lowry, V., Bureau, N. J., Lamontagne, M., Coutu, M. F., Lavigne, P., & Desmeules, F. (2020). Shoulder Rotator Cuff Disorders: A Systematic Review of Clinical Practice Guidelines and Semantic Analyses of Recommendations. Arch Phys Med Rehabil, 101(7), 1233-1242.
• Ekeberg, O. M., Bautz-Holter, E., Tveitå, E. K., Keller, A., Juel, N. G., & Brox, J. I. (2008). Agreement, reliability and validity in 3 shoulder questionnaires in patients with rotator cuff disease. BMC musculoskeletal disorders, 9(1), 1-9.
• El, O., Bircan, C., Gulbahar, S., Demiral, Y., Sahin, E., Baydar, M., Kizil, R., Griffin, S., & Akalin, E. (2006). The reliability and validity of the Turkish version of the Western Ontario Rotator Cuff Index. Rheumatology international, 26, 1101-1108.
• El, O., Bircan, C., Gulbahar, S., Demiral, Y., Sahin, E., Baydar, M., Kizil, R., Griffin, S., & Akalin, E. (2006). The reliability and validity of the Turkish version of the Western Ontario Rotator Cuff Index. Rheumatol Int, 26(12), 1101-1108.
• Field, Z., Miles, J., & Field, A. (2012). Discovering statistics using R. Discovering Statistics Using R, 1-992.
• Goldberg, B. A., Nowinski, R. J., & Matsen, F. A., 3rd. (2001). Outcome of nonoperative management of full-thickness rotator cuff tears. Clin Orthop Relat Res(382), 99-107.
• Harvie, P., Pollard, T. C., Chennagiri, R. J., & Carr, A. J. (2005). The use of outcome scores in surgery of the shoulder. J Bone Joint Surg Br, 87(2), 151-154.
• Huber, W., Hofstaetter, J. G., Hanslik-Schnabel, B., Posch, M., & Wurnig, C. (2005). [Translation and psychometric testing of the Western Ontario Rotator Cuff Index (WORC) for use in Germany]. Z Orthop Ihre Grenzgeb, 143(4), 453-460.
• Jensen, K. U., Bongaerts, G., Bruhn, R., & Schneider, S. (2009). Not all Rowe scores are the same! Which Rowe score do you use? J Shoulder Elbow Surg, 18(4), 511-514.
• Kirkley, A., Griffin, S., & Dainty, K. (2003). Scoring systems for the functional assessment of the shoulder. Arthroscopy, 19(10), 1109-1120.
• Lambers Heerspink, F. O., van Raay, J. J., Koorevaar, R. C., van Eerden, P. J., Westerbeek, R. E., van 't Riet, E., van den Akker-Scheek, I., & Diercks, R. L. (2015). Comparing surgical repair with conservative treatment for degenerative rotator cuff tears: a randomized controlled trial. J Shoulder Elbow Surg, 24(8), 1274-1281.
• Lapner, P. L., Sabri, E., Rakhra, K., McRae, S., Leiter, J., Bell, K., & Macdonald, P. (2012). A multicenter randomized controlled trial comparing single-row with double-row fixation in arthroscopic rotator cuff repair. J Bone Joint Surg Am, 94(14), 1249-1257.
• Lopes, A. D., Ciconelli, R. M., Carrera, E. F., Griffin, S., Faloppa, F., & Dos Reis, F. B. (2008). Validity and reliability of the Western Ontario Rotator Cuff Index (WORC) for use in Brazil. Clinical Journal of Sport Medicine, 18(3), 266-272.
• MacDermid, J. C., Bryant, D., Holtby, R., Razmjou, H., Faber, K., Balyk, R., Boorman, R., Sheps, D., McCormack, R., Athwal, G., Hollinshead, R., Lo, I., Bicknell, R., Mohtadi, N., Bouliane, M., Glasgow, D., Lebel, M. E., Lalani, A., Moola, F. O., . . . Drosdowech, D. (2021). Arthroscopic Versus Mini-open Rotator Cuff Repair: A Randomized Trial and Meta-analysis. Am J Sports Med, 49(12), 3184-3195.
• MacDonald, P., McRae, S., Leiter, J., Mascarenhas, R., & Lapner, P. (2011). Arthroscopic rotator cuff repair with and without acromioplasty in the treatment of full-thickness rotator cuff tears: a multicenter, randomized controlled trial. J Bone Joint Surg Am, 93(21), 1953-1960.
• Moosmayer, S., Lund, G., Seljom, U. S., Haldorsen, B., Svege, I. C., Hennig, T., Pripp, A. H., & Smith, H. J. (2019). At a 10-Year Follow-up, Tendon Repair Is Superior to Physiotherapy in the Treatment of Small and Medium-Sized Rotator Cuff Tears. J Bone Joint Surg Am, 101(12), 1050-1060.
• Mousavi, S. J., Hadian, M. R., Abedi, M., & Montazeri, A. (2009). Translation and validation study of the Persian version of the Western Ontario Rotator Cuff Index. Clinical rheumatology, 28, 293-299.
• Ranebo, M. C., Björnsson Hallgren, H. C., Holmgren, T., & Adolfsson, L. E. (2020). Surgery and physiotherapy were both successful in the treatment of small, acute, traumatic rotator cuff tears: a prospective randomized trial. J Shoulder Elbow Surg, 29(3), 459-470.
• Richards, C. D., Eubank, B. H. F., Lafave, M. R., Wiley, J. P., Bois, A. J., & Mohtadi, N. G. (2022). The responsiveness and validity of the Rotator Cuff Quality of Life (RC-QOL) index in a 2-year follow-up study. JSES Int, 6(4), 604-614.
• Thigpen, C. A., Shaffer, M. A., Gaunt, B. W., Leggin, B. G., Williams, G. R., & Wilcox, R. B., 3rd. (2016). The American Society of Shoulder and Elbow Therapists' consensus statement on rehabilitation following arthroscopic rotator cuff repair. J Shoulder Elbow Surg, 25(4), 521-535.
• Wessel, R. N., Wolterbeek, N., Fermont, A. J., Lavrijsen, L., van Mameren, H., & de Bie, R. A. (2018). Responsiveness and disease specificity of the Western Ontario Rotator Cuff index. Journal of orthopaedics, 15(2), 337-342.