Validation of the western ontario rotator cuff index in patients with arthroscopic rotator cuff repair: A study protocol

Arthroscopic rotator cuff repair is performed to improve quality of life. Therefore, disease specific health-related quality of life patient-administered questionnaires are needed. The WORC is a quality of life questionnaire designed for patients with disorders of the rotator cuff. The score is validated for rotator cuff disease, but not for rotator cuff repair specifically.The aim of this study is to investigate reliability, validity and responsiveness of WORC in patients undergoing arthroscopic rotator cuff repair.An approved translation of the WORC into Dutch is used. In this prospective study three groups of patients are used: 1. Arthroscopic rotator cuff repair; 2. Disorders of the rotator cuff without rupture; 3. Shoulder instability.The WORC, SF-36 and the Constant Score are obtained twice before therapy is started to measure reliability and validity. Responsiveness is tested by obtaining the same tests after therapy.Arthroscopic rotator cuff repair is performed with increasing frequency. In more than 90% of the patients results are reported to be good to excellent[1-9]. However, the question remains what good to excellent really means. Especially, the University of California Los Angeles (UCLA) Shoulder Rating Scale and Constant Score are used frequently [1-9].Authors use these instruments to classify results as 'excellent', 'good', 'fair' or 'poor'. Unfortunately the cut-off points vary and some authors use modified scores, making it difficult to compare results [1,4,5,8,10-12] as illustrated in Table 1.The UCLA Shoulder Rating Scale is a combination of physical examination and subjective evaluation of complaints of patients by the attending physician. No publications are available with respect to the development and validation of this instrument. Therefore it is unknown why the developers of this instrument assigned the various weights to the 5 domains. While not necessarily incorrect, it is thus far unsupported[13]. The Constant Score also consists of a c