Time Required to Achieve Clinically Significant Outcomes After Anteroinferior Arthroscopic Capsular Release for Shoulder Adhesive Capsulitis.

Autor:	Pasqualini I; Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA., Rossi LA; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Oyem PC; Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA., Tanoira I; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Hurley ET; Department of Orthopedic Surgery, Division of Hand and Upper Extremity, Duke University, Durham, North Carolina, USA., Ranalletta M; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Jazyk:	angličtina
Zdroj:	Orthopaedic journal of sports medicine [Orthop J Sports Med] 2024 Nov 04; Vol. 12 (11), pp. 23259671241275653. Date of Electronic Publication: 2024 Nov 04 (Print Publication: 2024).
DOI:	10.1177/23259671241275653
Abstrakt:	Background: The specific time required to reach clinically significant outcomes for patient-reported outcome measures (PROMs) after arthroscopic capsular release (ACR) for the treatment of shoulder adhesive capsulitis remains unknown. Purposes: To determine the time required to achieve the minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) score thresholds after ACR for visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons score (ASES), Single Assessment Numeric Evaluation (SANE), and Constant score and to identify patient factors associated with delayed achievement of these clinical benchmarks. Study Design: Case series; Level of evidence, 4. Methods: A prospective analysis was performed of patients who underwent ACR for the treatment of idiopathic shoulder adhesive capsulitis between October 2019 and October2020. Patients completed PROMs preoperatively and at 1, 2, 4, 6, and 12 months postoperatively. Threshold values for MCID and PASS were obtained from previous literature for the VAS, ASES, SANE, and Constant scores. Results: A total of 73 patients were included (mean age, 55.5 ± 9.3 years; body mass index [BMI], 26.6 ± 4.6 kg/m 2 ). By 1-year follow-up, the cumulative percentage of patients achieving the MCID and PASS for VAS, ASES, SANE, and Constant scores was 98.6%, 100%, 100%, and 98.6%, and 95.8%, 91.7%, 98.6%, and 84.9%, respectively. The median time required to reach the MCID thresholds for VAS, ASES, SANE, and Constant scores was 1, 1, 2, and 1 month, respectively. The median time required to reach the PASS thresholds for VAS, ASES, SANE, and Constant scores was 4, 4, 4, and 2 months, respectively. Factors associated with delayed achievement of MCID for SANE included higher BMI (hazard ratio [HR], 0.94; 95% CI, 0.88-0.99) and diabetes (HR, 0.49; 95% CI, 0.2-0.99). Age was associated with delayed achievement of the PASS for VAS. Conclusion: Most patients undergoing ACR achieved clinically significant outcomes within a 4-month timeframe. The majority of patients reached MCID thresholds on outcome measures within 1 to 2 months and achieved satisfactory symptom states within 2 to 4 months postoperatively. By delineating the timeline of patient-perceived benefits, these results provide useful data to set appropriate expectations, guide rehabilitation, and optimize outcomes after ACR. Competing Interests: The authors declared that they have no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. (© 2024 The Author(s).)
Databáze:	MEDLINE
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