Our orthopedic clinic just converted part of the practice to a patient-specific condition: rotator cuff tears. Two surgeons will be dedicated to that single diagnosis. What outcomes measure do you recommend for patients who are treated conservatively versus those who have surgery?
Test tools developed for shoulder outcomes measures often have a specific focus such as severity of motion loss or change in pain intensity. Some are designed to be used in research, while others assess shoulder instability in all forms of rotator cuff pathology.
Three main tools used with patients who have rotator cuff disease include the Rotator Cuff Quality of Life and Western Ontario Rotator Cuff Index. For patients who have had surgery for rotator cuff disease, there are a few additional tests such as the Rowe Rating Sheet for Bankart Repair, the Western Ontario Rotator Cuff index (WORC), and the Wolfgang criteria.
Here are a few details about each of these rotator cuff disease outcomes measures. The Rotator Cuff Quality of Life assesses five different areas including pain, physical complaints (and other symptoms), sports and recreation, work concerns, lifestyle issues, and social and emotional issues. So you can see that it offers information on a wide range of outcomes, not just pain.
The Western Ontarior Rotator Cuff Index also asks patients to rate their pain and physical symptoms, sports and recreation participation, work function, social and emotional function. It was designed to be used with surgical and nonsurgical care including partial and full-thickness rotator cuff tears.
The Wolfgang criteria rates results of rotator cuff surgical repair, so it's limited to that particular group of patients. Some experts suggest that to obtain the highest level of outcome assessment, a test of general health outcome should be done. Along with that, the clinician or researcher should also measure activity and administer a disease- or condition-specific questionnaire. Combined together these outcome measures will give a broad assessment of each patient -- even those who have a specific diagnosis of rotator cuff pathology.
Rick W. Wright, MD, and Keith M. Baumgarten, MD. Shoulder Outcomes Measures. In Journal of the American Academy of Orthopaedic Surgeons. July 2010. Vol. 18. No. 7. Pp. 436-444.
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