Post et al rated the functional outcome of patients following surgery for a torn rotator cuff. This can help determine the effectiveness of the operation. The authors are from Michael Reese Hospital in Chicago.
Parameters:
(1) pain
(2) active overhead motion
(3) comparison to other preoperative motions
Pain was graded in a range of 0 to 75. Preoperative function was graded from 0 to 25. The preoperative rating score was the combined score, which ranged from 0 to 100.
|
Pain |
Points |
|
severe disabling |
0 to 29 |
|
nondisabling pain |
30 - 74 |
|
absolutely no pain or discomfort with any activity |
75 |
The instructions for grading are not explicit. One approach is to create a 10 cm VAS (visual analogue scale), with anchors at:
(1) 0.1 to 1.5: minimal pain
(2) 1.6 to 3.0: mild pain
(3) 3.1 to 6.1: moderate pain
(4) 6.2 to 10.0: severe pain
This was created by the following process:
(1) 29 points defines severe pain
(2) 1 - 29/75 = 0.62 of interval; This would be at 6.2 cm along the VAS.
(3) The interval between 0 and 6.2 cm was halved and quartered for moderate, mild and minimal.
points for pain =
= 75 - (7.5 * (centimeters along VAS scale))
|
Post-Operative Pain |
Outcome |
|
70 - 75 |
excellent |
|
60 - 69 |
good |
|
50 - 59 |
fair |
|
<= 49 |
poor |
|
Active Overhead Motion |
Outcome |
|
> 160° |
excellent |
|
126 - 160° |
good |
|
75 - 125° |
fair |
|
< 75° |
poor |
Finally, the patient must have:
(1) attained at least the same level of preoperative passive motion
(2) no loss of any significant motion
Again, this was somewhat vague. One way to make it more operational is:
|
Post-Operative Motion |
Outcome |
|
much better than preoperative |
excellent |
|
better than preoperative |
good |
|
same as preoperative |
fair |
|
worse than preoperative |
poor |
Specialty: Surgery, orthopedic
ICD-10: ,
