Can Patients Accurately Recall their Preoperative Pain and Functional Scores Following Rotator Cuff Repair and Total Shoulder Arthroplasty?

Document Type : RESEARCH PAPER

Authors

1 Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USA.

2 Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USA

3 Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA.

4 The Rothman Institute at Thomas Jefferson University

5 925 Chestnut St 5th Floor

Abstract

Background: Accurate analysis of preoperative shoulder pain and function is important for understanding treatment efficacy and producing high quality research. Oftentimes, preoperative patient reported outcomes (PROs) are missing. Therefore the accuracy of recalled preoperative PROs may be significant. We investigate the ability of patients who underwent rotator cuff repair (RCR) or shoulder arthroplasty (TSA) to recall their preoperative PROs.

Methods: We identified 145 patients who underwent either RCR or TSA and had preoperative PROs. All patients completed the ASES, SANE, SST, and VAS surveys within 3 months prior to surgery. Patients were contacted between one and four years after surgery, and asked to recall their baseline pain and shoulder function prior to surgery. Mean difference was calculated by determining the difference between the mean recalled score and mean actual score. Intraobserver reliability analysis was performed, comparing recall and actual score for each using the 2-way mixed-effects intraclass correlation coefficient (ICC) model. ICC values > 0.75 were considered excellent, values between 0.4 and 0.75 were considered moderate, and values of < 0.4 demonstrated a weak agreement.

Results: For patients who underwent RCR, the mean differences between actual and recalled ASES, SANE, SST and VAS pain were 6.3 (p=0.004), 2.0 (p=0.155), -0.04 (p=0.625) and - 1.0 (p<0.001), respectively. In patients who underwent TSA, the mean differences between actual and recalled ASES, SANE, SST and VAS pain were 4.5 (p =0.038), -3.9 (p=0.262), -1.2 (p=0.001) and -1.5 (p<0.001), respectively. ASES, SST, and VAS show moderate reliability and SANE reliability was weak in both RCR and TSA populations. Patients had a tendency to recall higher pain scores than actual preoperative pain scores.

Conclusion: In patients who underwent RCR or TSA, there was too much variability between individual patient’s ability to accurately recall preoperative pain and function to reliably use recall data for research purposes.

Keywords



Articles in Press, Accepted Manuscript
Available Online from 25 December 2021
  • Receive Date: 02 November 2021
  • Accept Date: 19 December 2021
  • First Publish Date: 25 December 2021