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World J Orthop. Mar 18, 2015; 6(2): 244-251
Published online Mar 18, 2015. doi: 10.5312/wjo.v6.i2.244
Use of scoring systems for assessing and reporting the outcome results from shoulder surgery and arthroplasty
Simon Booker, Nawaf Alfahad, Martin Scott, Ben Gooding, W Angus Wallace
Simon Booker, Nawaf Alfahad, Martin Scott, Ben Gooding, W Angus Wallace, Nottingham Shoulder and Elbow Unit, Nottingham City Hospital, NG5 1PB Nottingham, United Kingdom
Author contributions: Booker S and Alfahad N researched the scoring systems and collated the data on the scoring systems; Alfahad N, Scott M and Gooding B supervised the development of the database of scoring systems; Gooding B and Wallace WA carried out the shoulder arthroplasty operations and edited the final article which was approved by all authors.
Conflict-of-interest: This article focuses on shoulder scoring systems used world-wide. None of the authors have any conflict of interest in relation to any of these shoulder scoring systems. The shoulder replacement results reported are for the Vaios shoulder replacement (marketed by JRI Orthopaedics Ltd) and are the results for a consecutive series of primary shoulder replacements carried out by the Senior Author (WAW) who was the co-designer of the Vaios shoulder replacement and has a Consultancy agreement with JRI Orthopaedics Ltd. None of the other co-authors have any conflict of interest in relation to shoulder replacement surgery.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: W Angus Wallace, Professor, Nottingham Shoulder and Elbow Unit, Nottingham City Hospital, Hucknall Road, NG5 1PB Nottingham, United Kingdom. angus.wallace@rcsed.ac.uk
Telephone: +44-115-9691169 Fax: +44-115-9628062
Received: March 11, 2014
Peer-review started: March 12, 2014
First decision: April 30, 2014
Revised: December 9, 2014
Accepted: December 18, 2014
Article in press: December 19, 2014
Published online: March 18, 2015
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.