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. 2022 Mar 22;10(3):23259671221084978.
doi: 10.1177/23259671221084978. eCollection 2022 Mar.

The Patient Acceptable Symptom State as a Predictor of the Sports Activity Available State After Arthroscopic Rotator Cuff Repair

Dong Min Kim  1 , In-Ho Jeon  2 , Ho Yeon Kim  2 , Jeong Hee Park  2 , Hyojune Kim  3 , Kyoung Hwan Koh  2
Affiliations

The Patient Acceptable Symptom State as a Predictor of the Sports Activity Available State After Arthroscopic Rotator Cuff Repair

Dong Min Kim et al. Orthop J Sports Med. .

Abstract

Background: The patient acceptable symptom state (PASS) has emerged as a metric for evaluating patient satisfaction after treatment. There is little research on the relationship between sports activity and PASS values after arthroscopic rotator cuff repair (ARCR).

Purpose: To (1) introduce the sports activity available state (SAAS) as an indicator of whether sports activities are possible based on patient symptoms after ARCR, (2) investigate the correlation between the SAAS and PASS, (3) predict the SAAS using derived PASS values, and (4) identify factors for achieving the PASS and SAAS.

Study design: Case-control study; Level of evidence, 3.

Methods: Included were 201 patients who underwent ARCR between January 2015 and December 2016. At a mean follow-up of 38.7 ± 7.0 months, anchor questions were used to classify patients as SAAS+ (sports group) or SAAS- (nonsports group) and derive the PASS values for the pain visual analog scale (pVAS), American Shoulder and Elbow Surgeons (ASES), and Single Assessment Numeric Evaluation (SANE). The authors analyzed the correlation and difference between PASS and SAAS acquisition, and univariate and multivariate logistic regression analyses were performed to determine factors for PASS and SAAS achievement.

Results: The final PASS values for the pVAS, ASES, and SANE were 0.5, 93.5, and 82.5, respectively. A significant correlation existed between PASS and SAAS acquisition (phi correlation coefficient, 0.647; P < .001). Sensitivity and specificity were >0.7 for all outcome scores when predicting SAAS using PASS values. A higher preoperative ASES score was significantly associated with achieving both the SAAS (OR, 1.032 [95% CI, 1.005-1.059]; P = .018) and PASS (OR, 2.556 [95% CI, 1.753-3.726]; P < .001). Diabetes (OR, 0.348 [95% CI, 0.130-0.931], P = .036) and a large to massive tear (OR, 0.378 [95% CI, 0.162-0.884]; P = .025) were significantly negatively associated with achieving the SAAS.

Conclusion: The authors found the SAAS to be significantly correlated with the PASS. Also, SAAS was able to be predicted using the PASS value. Patients with higher preoperative ASES scores had higher odds of achieving both the PASS and SAAS, and patients with diabetes and those with large to massive tears had lower odds of achieving the SAAS.

Keywords: patient acceptable symptom state; rotator cuff injuries; sports activity available state; visual analog scale.

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Conflict of interest statement

The authors declared that they have no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Flowchart showing the overall progress of this study. MRI, magnetic resonance imaging; POD, postoperative day; ROM, range of motion; SCR, superior capsular reconstruction.
Figure 2.
Figure 2.
Comparison of final outcome scores between the (A) sports activity available state (SAAS) nonsports and sports groups and (B) patient acceptable symptom state (PASS) unsatisfied and satisfied groups. ASES, American Shoulder and Elbow Surgeons; pVAS, pain visual analog scale; SANE Single Assessment Numeric Evaluation.
See this image and copyright information in PMC

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