Response shift of the Western Ontario Rotator Cuff index in patients undergoing arthroscopic rotator cuff repair

Hypothesis: This study determined the response shift in patients undergoing rotator cuff repair using the Western Ontario Rotator Cuff index (WORC), a disease-specific quality of life questionnaire. We hypothesized there would be a response shift with a positive recalibration (overestimated their preoperative disability) on the WORC and increases over time. Methods: The study prospectively included 36 patients undergoing arthroscopic rotator cuff repair. At baseline, 3 months (T1), and 1 year (T2) after surgery the WORC, EuroQol (EQ)-5D-3L, and the patient's level of satisfaction after surgery were scored. To evaluate the response shift, patients also completed the WORC at 3 months (Pre-T1) and 1 year (Pre-T2) as how they perceived themselves to have been before surgery. Results: The result on Pre-T1 and Pre-T2 results revealed that patients retrospectively rated their overall WORC score comparable with the baselineWORC score (Pre-T0; T0 = 40.5 +/- 18.4, Pre-T1 = 45.0 +/- 22.7, Pre-T2 = 34.3 +/- 21.3). No response shift was observed on all domains except a negative recalibrated response shift for emotional disability on T1 (P = .04). Conclusions: No significant group-level response shift was observed using the WORC, except for the subdomain emotional disability at 3 months after arthroscopic rotator cuff repair. With the absence of any shift in patient's perception on the self-administered quality of life-related WORC questionnaire, this study suggests one could retrospectively reliably conduct group-level preoperative baseline information on quality of life up to 1 year after surgery. Level of evidence: Development or Validation of Outcome Instrument (C) 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.