Evaluation of Rotator Cuff Repair Using Korean Shoulder Scoring System

Abstract

Background: Assessment of the clinical outcomes after rotator cuff repair is essential for their effectiveness on treatment. The Korean Shoulder and Elbow Society devised the Korean Shoulder Scoring System (KSS) for patients with rotator cuff disorder. The purpose of this study was to evaluate the availability of the KSS for assessment of clinical outcomes in patients after arthroscopic rotator cuff repair, and for comparison with other appraisal scoring systems. Methods: A total of 130 patients with partial-thickness or full-thickness rotator cuff tear who underwent arthroscopic repair using a single row or double row suture bridge technique were enrolled. The average follow-up period was 25.9 months. All patients were classified according to various factors. Comparison within corresponding categories was performed, and the correlation between the KSS and other shoulder assessment methods including University of California Los Angeles (UCLA), Constant and American Shoulder and Elbow Surgeons (ASES) score was analyzed. Results: Total score of the KSS response had increased from 59.6 preoperatively to 88.96 at last follow-up. All KSS domains, including function, pain, satisfaction, range of motion, and muscle power had improved up to 24 months postoperatively. Statistical significance was observed mainly in preoperative measurements with number and size of torn tendons, and greater than or equal to grade 3 of fatty infiltration. The KSS was best correlated with the UCLA scoring system in both preoperative (r=0.785) and postoperative (r=0.951) measurements. Conclusions: The KSS was highly reliable and valid as a discriminative instrument, and it showed strong correlation with ASES and UCLA scoring systems. (Clin Shoulder Elbow 2015;18(4):206-210)

Preoperative Korean Shoulder Scoring System Correlates with Preoperative Factors of Rotator Cuff Tears

“…This suggests that the clinical feature in the rotator cuff tears may be related to the tendon involvement with regards to IST involvement rather than just the tendon tear. Unlike a previous study by Shin et al [ 18 ], our study demonstrated that the preoperative factor affecting preoperative KSS is with respect to which tendon is torn, and not just the number of the tendon(s) involved.…”

“…Several studies reported that tear size correlated with the scores of shoulder scoring systems. Shin et al [ 18 ] reported that the preoperative KSS scores of patients with small to medium sized tears were significantly higher than those for patients with large to massive sized tears. According to the study by Park et al [ 12 ], the size of the tear correlated with the ASES score, and further demonstrated that the tear size in the AP direction was a preoperative factor affecting rotator cuff healing.…”

“…Nho et al [ 28 ] reported that number of tendons involved was a significant prognostic factor after rotator cuff repair. According to the study by Shin et al [ 18 ], the preoperative KSS scores of patients with multiple torn tendons were significantly lower than those for patients with a single torn tendon. We similarly found that additional tears of other tendons along with tears of the supraspinatus tendon showed a tendency to decrease the preoperative KSS, although it was statistically not significant.…”

“…Gladstone et al [ 29 ] reported that atrophy and fatty infiltration of the IST muscle were the only independent predictors of the ASES and Constant scores. Shin et al [ 18 ] reported that a significantly inferior score in the preoperative KSS response was observed in patients with preoperative fatty degeneration greater than or equal to stage 3 of the Goutallier grading system. We similarly observed a close correlation between fatty infiltration of the cuff muscle and the preoperative KSS scores.…”

“…This assessment tool emphasizes the patient-oriented self-evaluation to avoid bias produced by observer-based evaluation, and contains the additional muscle endurance domain, which was included only in the KSS [ 17 ]. The KSS is highly reliable and valid as a discriminative instrument, and shows strong correlation with the ASES and University of California at Los Angeles scoring systems [ 18 ].…”