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Clinical Outcomes Validate RAND/UCLA Appropriateness Criteria Algorithm for Anatomic TSA to Streamline the Clinical Decision-making Process

Presented by Sarav Shah, MD at the World Orthopedics Conference in Madrid, Spain

In this presentation, Dr. Shah discusses the validation of the RAND/UCLA appropriateness criteria for anatomic total shoulder arthroplasty. Using data from 390 patients, the study classified candidates as "appropriate", "inconclusive", or "inappropriate" and examined patient-reported outcomes. The appropriate group as identified by our Appropriateness Use Criteria had a significantly greater proportion of patients who achieved MCID (95.8%) and SCB (92.6%).

Our data clinically validates an anatomic TSA appropriateness criteria algorithm, allowing for more rapid and reliable determination of aTSA candidacy. “Appropriate” patients were more likely to achieve MCID and SCB for ASES scores compared to “inappropriate” patients. Among “appropriate” patients who did not achieve SCB, 50% of them had a postoperative complication. This was a significantly higher proportion of postoperative complications among those that did not achieve SCB across all three groups. Only 7.1% of patients who did not achieve SCB in the inappropriate group had a postoperative complication. Thus, it can be inferred that the failure to
reach SCB in the appropriate group was likely due to a postoperative complication, whereas for patients deemed “inappropriate,” failure to reach SCB may be secondary to factors accounted for within our algorithm.