Minimal Clinically Important Differences (MCID) for the Western Ontario Osteoarthritis of the Shoulder Index (WOOS) and the Oxford Shoulder Score (OSS)

Marc Randall Kristensen Nyring, Bo Sanderhoff Olsen, Alexander Amundsen, Jeppe Vejlgaard Rasmussen Department of Orthopedic Surgery, Herlev and Gentofte Hospital, Hellerup, 2900, DenmarkCorrespondence: Marc Randall Kristensen NyringDepartment of Orthopedic Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte Hospitalsvej 12, Hellerup, 2900, DenmarkTel +45 38673840Email marc.randall.kristensen.nyring@regionh.dkBackground: The minimal clinically important difference (MCID) is an important instrument in the interpretation of changes in patient-reported outcome measures (PROM). To our knowledge, no MCID of the Western Ontario Osteoarthritis of the Shoulder Index (WOOS) score has ever been reported and no studies have reported an MCID for the Oxford Shoulder Score (OSS) based on patients with glenohumeral osteoarthritis, treated with an anatomical total shoulder arthroplasty (aTSA). The aim of this study was to determine MCID for WOOS and OSS in a cohort of patients with glenohumeral osteoarthritis treated with an aTSA.Methods: All patients treated with an aTSA for glenohumeral osteoarthritis at our institution between March 2017 and February 2019 were included. Each patient completed the WOOS and the OSS preoperatively and one year postoperatively. At one year, the patients were asked to rate their overall improvement on a 7-point scale. We used an anchor-based method as our primary method to calculate the MCID, supported by two different distribution-based methods.Results: A total of 45 primary aTSA were included. The MCID of WOOS was 12.3 according to the anchor-based method and 14.2 and 10.3 according to the two distribution-based methods. The MCID of OSS was 4.3 according to the anchor-based method and 5.8 and 4.3 according to the two distribution-based methods.Conclusion: The anchor-based method is considered superior to the distribution-based method, and therefore we advocate to use this as MCID. For patients with glenohumeral osteoarthritis treated with an aTSA, the MCID values were 12.3 points for WOOS and 4.3 points for OSS. To our knowledge, this is the first study to report a MCID value for WOOS and the first study to report a MCID value for OSS in this subgroup of patients.Keywords: minimal clinically important difference, glenohumeral osteoarthritis, anatomical total shoulder arthroplasty, patient reported outcome measures