An analysis of the Oxford Shoulder Score and its relationship to early joint revision in the New Zealand Joint Registry.

Background: Primary shoulder arthroplasties significantly improve shoulder function and have acceptable prosthesis survival for various indications. Currently, no validated shoulder questionnaire exists that can anticipate the early failure of primary shoulder arthroplasties. This study hypothesized that the Oxford Shoulder Score (OSS) after primary shoulder arthroplasty at 6 months would be significantly associated with early revision procedures.

Methods: Data on all primary and revision shoulder arthroplasties covering the period of January 1, 1999, to December 31, 2019, were obtained from the New Zealand Joint Registry. The OSS questionnaires at 6 months were analyzed with regard to their relationship to revision within 2 years from the questionnaire date. Confounding risk factors were adjusted for in multivariate logistic regression analysis.

Results: Statistical analysis revealed that the 6-month OSS had a significant association with revision in the following 2 years for anatomic total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RSA), and shoulder hemiarthroplasty (HA) (P < .001). An OSS of ≤44 for TSAs, ≤40 for RSAs, and ≤33 for HAs accounted for 68.9%, 63.1%, and 50.7%, respectively, while capturing at least 85% of revisions for all prostheses within the following 2 years.

Conclusions: This study confirms that a poor OSS at 6 months is an independent risk factor for early revision after TSA, RSA, and HA. We recommend discharging patients with a 6-month OSS greater than the identified threshold values for each prosthesis to improve resource efficiency.