Scoring systems for shoulder conditions

We evaluated the comparability of four commonly used shoulder scoring systems in the United States. Fifty-two patients had 53 shoulder stabilization procedures. Surgical procedures included 34 open Bankart-type repairs, 15 capsular shifts, and 4 arthroscopic stabilizations. Results were assessed using the following scales: 1) Rowe, 2) modified-Rowe, 3) University of California at Los Angeles, and 4) the pre-1994 American Shoulder and Elbow Surgeons scale. No consensus has been reached on the relative value of these systems. We observed significant variations using these systems. A majority of our patients (85%) had excellent results when the University of California at Los Angeles scoring system was used. However, only 38% of the patients had excellent results when the modified-Rowe scale was used. Overall, good or excellent results were observed in 89% to 95% of the patients using these four scoring systems. The University of California at Los Angeles score correlated poorly with the other systems, Interrater reliability between the four systems was poor. Generalized results of an investigation can be biased based on the selection of a scoring system. The lack of a widely accepted scoring system for the shoulder limits comparison of management for shoulder conditions. Thus, a widely accepted shoulder scoring system is needed.