Scholarlink

Background <p>Arthroscopic rotator cuff repair (ARCR) is a common procedure, and postoperative shoulder stiffness (POSS) is one of its most frequent adverse events, potentially necessitating individualized therapy. Our objectives were to update and internally validate a model predicting the occurrence of POSS for patients undergoing an ARCR.</p> Methods <p>We prospectively enrolled 973 patients undergoing primary ARCR included in the ARCR_Pred dataset. A two-round Delphi survey with 53 surgeons established a consensus definition of POSS within 6 months postoperatively and a ranking of candidate prognostic factors. Treating surgeons estimated POSS risk immediately after surgery. We externally validated an existing POSS model and developed updated multivariable logistic regression models using complete-case and multiple imputed datasets.</p> Results <p>We achieved a high consensus (88%) on the POSS definition among 44 responding shoulder surgeons, who also ranked the prognostic relevance of 71 factors for the prediction of POSS. The newly developed ARCR_Pred-POSS included 7 factors (age, acromiohumeral distance, symptom duration, baseline external rotation, active baseline abduction, baseline Oxford Shoulder Score, and surgery duration) and demonstrated superior discrimination (AUC = 0.735) and calibration (slope = 1.022) compared to the original POSS model (AUC = 0.581, slope = 0.508). Surgeons tended to overestimate the risk of POSS in their patients (AUC = 0.563, slope = 1.241).</p> Conclusions <p>These findings support the continued development of prediction models and provide valuable outputs for optimizing surgical timing, indications, and personalized rehabilitation.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Update of a prediction model for postoperative shoulder stiffness after arthroscopic rotator cuff repair

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年10月2日

查看全文
  • Thomas Stojanov,
  • Soheila Aghlmandi,
  • Andreas Marc Müller,
  • Philipp Moroder,
  • Alexandre Lädermann,
  • Cornelia Baum,
  • Claudio Rosso,
  • Philipp Moroder,
  • Doruk Akgün,
  • Isabella Weiss,
  • Eduardo Samaniego,
  • Thomas Suter,
  • Sebastian A. Müller,
  • Markus Saner,
  • Claudia Haag-Schumacher,
  • Mai Lan Dao Trong,
  • Carlos Buitrago-Tellez,
  • Julian Hasler,
  • Ulf Riede,
  • Beat Moor,
  • Matthias Biner,
  • Nicolas Gallusser,
  • Christoph Spormann,
  • Britta Hansen,
  • Holger Durchholz,
  • Gregory Cunningham,
  • Alexandre Lädermann,
  • Michael Schär,
  • Rainer Egli,
  • Stephanie Erdbrink,
  • Kate Gerber,
  • Paolo Lombardo,
  • Johannes Weihs,
  • Matthias Flury,
  • Ralph Berther,
  • Christine Ehrmann,
  • Larissa Hübscher,
  • David Schwappach,
  • Karim Eid,
  • Susanne Bensler,
  • Yannick Fritz,
  • Emanuel Benninger,
  • Philemon Grimm,
  • Markus Pisan,
  • Markus Scheibel,
  • Laurent Audigé,
  • Daniela Brune,
  • Marije de Jong,
  • Stefan Diermayr,
  • Marco Etter,
  • Florian Freislederer,
  • Michael Glanzmann,
  • Cécile Grobet,
  • Christian Jung,
  • Fabrizio Moro,
  • Ralph Ringer,
  • Jan Schätz,
  • Hans-Kaspar Schwyzer,
  • Martina Wehrli,
  • Barbara Wirth,
  • Christian Candrian,
  • Filippo Del Grande,
  • Pietro Feltri,
  • Giuseppe Filardo,
  • Francesco Marbach,
  • Florian Schönweger,
  • Bernhard Jost,
  • Michael Badulescu,
  • Stephanie Lüscher,
  • Fabian Napieralski,
  • Lena Öhrström,
  • Martin Olach,
  • Jan Rechsteiner,
  • Jörg Scheler,
  • Christian Spross,
  • Vilijam Zdravkovic,
  • Matthias A. Zumstein,
  • Annabel Hayoz,
  • Julia Müller-Lebschi,
  • Karl Wieser,
  • Paul Borbas,
  • Samy Bouaicha,
  • Roland Camenzind,
  • Sabrina Catanzaro,
  • Christian Gerber,
  • Florian Grubhofer,
  • Anita Hasler,
  • Bettina Hochreiter,
  • Roy Marcus,
  • Farah Selman,
  • Reto Sutter,
  • Sabine Wyss,
  • Christian Appenzeller-Herzog,
  • Andreas Marc Müller,
  • Soheila Aghlmandi,
  • Cornelia Baum,
  • Franziska Eckers,
  • Kushtrim Grezda,
  • Simone Hatz,
  • Sabina Hunziker,
  • Thomas Stojanov,
  • Mohy Taha,
  • Giorgio Tamborrini-Schütz,
  • Laurent Audigé

摘要

Background

Arthroscopic rotator cuff repair (ARCR) is a common procedure, and postoperative shoulder stiffness (POSS) is one of its most frequent adverse events, potentially necessitating individualized therapy. Our objectives were to update and internally validate a model predicting the occurrence of POSS for patients undergoing an ARCR.

Methods

We prospectively enrolled 973 patients undergoing primary ARCR included in the ARCR_Pred dataset. A two-round Delphi survey with 53 surgeons established a consensus definition of POSS within 6 months postoperatively and a ranking of candidate prognostic factors. Treating surgeons estimated POSS risk immediately after surgery. We externally validated an existing POSS model and developed updated multivariable logistic regression models using complete-case and multiple imputed datasets.

Results

We achieved a high consensus (88%) on the POSS definition among 44 responding shoulder surgeons, who also ranked the prognostic relevance of 71 factors for the prediction of POSS. The newly developed ARCR_Pred-POSS included 7 factors (age, acromiohumeral distance, symptom duration, baseline external rotation, active baseline abduction, baseline Oxford Shoulder Score, and surgery duration) and demonstrated superior discrimination (AUC = 0.735) and calibration (slope = 1.022) compared to the original POSS model (AUC = 0.581, slope = 0.508). Surgeons tended to overestimate the risk of POSS in their patients (AUC = 0.563, slope = 1.241).

Conclusions

These findings support the continued development of prediction models and provide valuable outputs for optimizing surgical timing, indications, and personalized rehabilitation.