Evaluating shoulder pain and disability index (SPADI) outcomes post-rotator cuff repair: Minimal clinically important difference (MCID), patient acceptable symptom state (PASS) and substantial clinical benefit (SCB) analysis.

Abstract

BackgroundThe Shoulder Pain and Disability Index (SPADI) is one of the most widely used Patient Reported Outcome Measures designed to assess the severity of pain and disability in patients with shoulder conditions.ObjectiveThe aim of the study is to define the clinically significant outcomes of the Minimum Clinically Important Difference (MCID), Substantial Clinical Benefit (SCB) and Patient Acceptable Symptom State (PASS) for the SPADI scores after Rotator Cuff Repair (RCR).MethodsThe present study takes into account patients undergone RCR with a 6-month follow-up. The MCID, PASS and SCB of the SPADI score were evaluated using both distribution and anchor approaches.ResultsFifty-nine patients (mean aged 60.3 ± 13.1 years) who had undergone RCR in a single surgical center were retrospectively included. The MCID cutoff of the SPADI total score after RCR from the initial evaluation to 6 months post-operatively was 17 (95% CI:13.6,20.4). The outcome measures for the MCID and SCB values of the SPADI pain score were 26 (95% CI:22.3,29.7) and 37 (95% CI:33.4,40.6), respectively. The MCID threshold of the SPADI disability score was 21.9 (95% CI:18.7,25.1). A value of at least 76.9 (95% CI:73.4,80.4), 75 (95% CI:71.6,78.4), and 78.1 (95% CI:74.6,81.6) for SPADI total, pain, and disability dimensions, represented the PASS.ConclusionsThe study shows significant improvements in SPADI scores after RCR, suggesting that could lead to meaningful pain relief and functional recovery. The findings indicate that a post-operative SPADI total score of at least 76.9 correlates with patient satisfaction regarding shoulder health.