Use of scoring systems for assessing and reporting the outcome results from shoulder surgery and arthroplasty

Abstract

To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit. A total of 174 research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score (CS) and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. CSs of < 30 = unsatisfactory; 30-39 = fair; 40-59 = good; 60-69 = very good; and 70 and over = excellent. The most popular shoulder scoring systems in North America were Simple Shoulder Test and American shoulder and elbow surgeons standard shoulder assessment form score and in Europe CS, Oxford Shoulder Score and DASH score.

Keywords: Shoulder joint; Arthroplasty; Replacement; Scoring methods; Operations; Surgery; Surgical therapy; Assessment; Patient outcomes; Classification

Core tip: We have identified the most commonly used shoulder scoring systems used when results of surgery are published. The constant score (CS) can be used to categorize the outcomes after shoulder arthroplasty into unsatisfactory; fair; good; very good; and excellent. This be carried out using both the original CS and the Adjusted (for age and sex) CS. For the majority of orthopaedic surgeons the reporting of outcomes in this way is clearer than providing the mean and standard deviation of one of the commonly used shoulder scoring systems.