Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association · 2025
Constant-Murley score categorization to assess outcomes after reverse shoulder arthroplasty following complex proximal humeral fracture.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Miralles-Muñoz Francisco Antonio, Sebastiá-Forcada Emilio
Аннотация
BACKGROUND: The Constant-Murley (CM) score is considered the gold standard of shoulder scoring systems. However, it does not include scoring categorization, and in some acute traumatic processes, a paired comparative analysis is not feasible. The purpose of this study was to determine cutoff values for the CM score that indicate a specific category on the outcome score following reverse total shoulder arthroplasty (rTSA) for fracture.
METHODS: Consecutive patients with complex proximal humeral fracture who underwent rTSA from 2010 to 2022, were included in the study. Two years of postoperative follow-up was required. Postoperative clinical evaluations were conducted using the CM and University of California, Los Angeles (UCLA) scores. The correlation between CM and UCLA scores was analyzed. Then, the receiver-operating characteristic (ROC) curve was utilized to determine the cutoff points in CM scores that most effectively distinguished between categories. The UCLA categories were used as the external criterion.
RESULTS: 132 patients completed the evaluations at the 2-year follow-up. Among them, 112 (84.8 %) were females and 20 (15.2 %) were males, with a mean age of 73.5 years. The UCLA score showed a strong correlation with the CM score (r = 0.936; 95% CI 0.911-0.954; p = 0.000). For the CM score, the cutoff for an excellent outcome was 67.5 (AUC 0.963, 95% CI 0.925-1.000), 56.5 (AUC 0.920, 95% CI 0.872-0.969) for good, 41.5 (AUC 0.701, 95% CI 0.617-0.784) for fair, and <41.5 (AUC 0.965, 95% CI 0.939-0.990) for poor.
DISCUSSION: According to the cut-off values in the CM score used to categorize the outcomes after rTSA in proximal humeral fractures, an excellent outcome was considered a score equal to or greater than 68, good between 57 and 67 points, fair between 41 and 56 points, and a poor outcome with a score equal to or less than 40 points.
LEVEL OF EVIDENCE: III.
METHODS: Consecutive patients with complex proximal humeral fracture who underwent rTSA from 2010 to 2022, were included in the study. Two years of postoperative follow-up was required. Postoperative clinical evaluations were conducted using the CM and University of California, Los Angeles (UCLA) scores. The correlation between CM and UCLA scores was analyzed. Then, the receiver-operating characteristic (ROC) curve was utilized to determine the cutoff points in CM scores that most effectively distinguished between categories. The UCLA categories were used as the external criterion.
RESULTS: 132 patients completed the evaluations at the 2-year follow-up. Among them, 112 (84.8 %) were females and 20 (15.2 %) were males, with a mean age of 73.5 years. The UCLA score showed a strong correlation with the CM score (r = 0.936; 95% CI 0.911-0.954; p = 0.000). For the CM score, the cutoff for an excellent outcome was 67.5 (AUC 0.963, 95% CI 0.925-1.000), 56.5 (AUC 0.920, 95% CI 0.872-0.969) for good, 41.5 (AUC 0.701, 95% CI 0.617-0.784) for fair, and <41.5 (AUC 0.965, 95% CI 0.939-0.990) for poor.
DISCUSSION: According to the cut-off values in the CM score used to categorize the outcomes after rTSA in proximal humeral fractures, an excellent outcome was considered a score equal to or greater than 68, good between 57 and 67 points, fair between 41 and 56 points, and a poor outcome with a score equal to or less than 40 points.
LEVEL OF EVIDENCE: III.