M. Skutek et al., Outcome analysis following open rotator cuff repair. Early effectiveness validated using four different shoulder assessment scales, ARCH ORTHOP, 120(7-8), 2000, pp. 432-436
Evaluation of upper extremity function after reconstructive surgery is incr
easingly important both to predict outcome and for the control of cost-effe
ctiveness. Three validated, self-administered shoulder questionnaires were
applied prospectively in 23 otherwise healthy patients with rotator cuff de
ficiency and correlated to the Constant-Murley Shoulder Score and a visual
analogue scale for satisfaction. Seven women and 16 men with combined tears
of supraspinatus and infraspinatus (mean age 55.3 +/- 10.5 years, r/l: 14/
9, follow-up 57.8 +/- 15.7 weeks) were gathered prospectively and evaluated
pre- and postoperatively with the American Shoulder and Elbow Surgeons (AS
ES) Shoulder Index, the Simple Shoulder Test (SST) and the Disabilities of
the Arm, Shoulder and Hand Module (DASH questionnaire). Additionally, a vis
ual analogue scale for satisfaction was employed. All four scores and the v
isual analogue scale revealed improvement at a statistically significant le
vel (P < 0.01) after surgery. All questionnaires showed a significant corre
lation with the Constant-Murley Shoulder Score (ASES: r = 0.871, P < 0.01;
DASH: I = -0.758, P < 0.01, SST: r- = 0.494, P < 0.05, Pearson's correlatio
n coefficient). Taken together, all questionnaires were easy to apply, and
reliable evaluation of shoulder function was possible with significant corr
elation to the Constant-Murley Shoulder Score postoperatively. The SST was
easy to apply, and compound outcome analysis was possible with the ASES Sho
ulder Index and DASH questionnaire. The DASH scale was the most complex eva
luation instrument. The Constant-Murley Shoulder Score comprises a physical
examination, which is advantageous but restricts the application to the of
fice. For postoperative assessment without the patient having to return to
the clinic, the ASES Shoulder Index is preferred because of its good correl
ation to the Constant-Murley Shoulder Score (r = 0.871) and the visual anal
ogue scale for satisfaction (r = 0.762).