S Roche

Technical difficulty in component sizing and positioning in humeral resurfacing: Relationship to clinical outcomes

Introduction : Resurfacing of the glenohumeral joint has gained popularity since its first introduction. Among other advantages, it is reported to allow closer replication of individual anatomy – failure of which may produce inferior clinical results. We review a cohort of patients who had undergone proximal humeral resurfacing, to evaluate certain radiological parameters of component sizing and positioning, and to correlate these with the clinical outcomes.

Reliability of shoulder symptom recall after 1 year in a retrospective application of the Oxford Shoulder Score

Background The accuracy of retrospective recall of shoulder symptoms has not been well documented. This prospective study assesses the ability of patients to recall their preoperative shoulder function one year after a surgical intervention, using the Oxford Shoulder Score (OSS). Methods 35 patients completed an OSS before undergoing shoulder surgery. One year later, patients were asked to recall their symptoms prior to their surgery. The recalled OSS of the patients as a group was compared to their preoperative score. The recall bias of each test pair was assessed with a Bland – Altman plot. Results On recall after a mean of 12.6 months, the mean OSS from the index assessment increased from 36.25 to 38.25 points. The mean difference of 2 points for the patients as a group was not significant (p = 0.14). The statistical limits of agreement of the Bland – Altman plot were set at +/-2 SD = 14.079 points. The plotted points showed fair correlation between each individual test pair. Conclusion The recall of symptoms of a large group of patients at 1 year after the index intervention appears to have a moderate correlation with the preoperative scoring. Although statistically acceptable, this limit of agreement is much larger than the 4.5-point difference, established to be clinically relevant in prior studies. The variation seen within the scores at the individual level suggests that these data cannot be used as a retrospective tool.