Paper 79: Increasing Shoulder Osteoarthritis Severity (SOAS) Score Predicts Lower PROMIS-UE Score Following Rotator Cuff Repair

Abstract

Objectives:

Mild to moderate glenohumeral osteoarthritis (GHOA) is a common finding among patients who are evaluated for rotator cuff (RC) tears. However, the impact of pre-operative shoulder joint degeneration on patient-reported outcomes (PROs) following RC repair (RCR) is not well-established. Certain studies have reported a negative association between radiographic findings of glenohumeral osteoarthritis (GHOA) and RCR PROs, while other studies have found no substantial association. The purpose of this study was to apply the MRI-based Shoulder Osteoarthritis Severity (SOAS) score to the evaluation of patients undergoing RCR and determine the relationship between pre-operative shoulder pathology present on MRI with post-operative PROMIS-UE scores. We hypothesized that patients with higher pre-operative SOAS scores, indicating greater shoulder pathology, would have lower post-operative PROMIS-UE scores following RCR.

Methods:

Seventy-one MRIs corresponding to 71 patients were analyzed by two independent reviewers and scored using the SOAS criteria. Intraclass correlation coefficients were calculated for total SOAS score as well as for each sub-score. Spearman’s correlations were calculated between averaged SOAS scores, patient demographics, and PROMIS-UE scores. Linear regression analysis was performed between the independent variables of patient age, sex, BMI, and significant SOAS score components determined by univariate analysis with the dependent variable of PROMIS-UE score. Significance was defined as p<0.05.

Results:

The mean PROMIS-UE score of this cohort was 51.5 ± 7.5 (Table 1), while the average total SOAS score was 21.5 ± 8.4 (Table 2). There was a negative correlation between increasing total SOAS score and worsening post-operative PROMIS-UE score (r = -0.24, p = 0.04) (Table 3). Both cartilage wear (r = -0.33, p = 0.0045) and AC joint degeneration (r = -0.24, p = 0.048) individually demonstrated negative correlations with PROMIS-UE score (Table 3). SOAS cartilage score was an independent negative predictor of PROMIS-UE score in a multiple variable linear regression with patient age and sex (β = -1.05, p = 0.038) (Table 4).

Conclusions:

In this cohort of patients undergoing RCR, increasing pre-operative total SOAS score was predictive of lower post-operative PROMIS-UE scores. SOAS sub-scores with the strongest negative correlations with PROMIS-UE scores included cartilage wear and AC joint degeneration. Cartilage subscore was negatively correlated with PROMIS-UE scores independent of patient demographic factors in multivariate analysis. Pre-operative GH cartilage wear and AC joint degeneration may warrant particular attention and counseling in patients undergoing RCR.

Table 1.

Characteri&tici of Study Subject

Table 2.

ICCs and Average SQAS Scores

Table 3.

Summary of Correlations

Table 4.

Multivariate Regression of SOAS Variables to Predict PROMIS-UE