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The Constant score in normal shoulders.

Edward H Yian1, Aarun J Ramappa, Oernulf Arneberg

  • 1Department of Orthopaedics, University of Zürich/Balgrist, Zürich, Switzerland.

Journal of Shoulder and Elbow Surgery
|March 25, 2005
PubMed
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Contemporary shoulder scores differ from original Constant-Murley values. Relative Constant scores may overestimate shoulder function in older adults and women, necessitating concurrent reporting of absolute scores.

Area of Science:

  • Orthopedics
  • Shoulder Surgery
  • Musculoskeletal Research

Background:

  • The Constant-Murley shoulder score is a widely used clinical outcome measure.
  • Relative scores are calculated against an age- and sex-matched normal population from Constant's original research.
  • Contemporary populations may differ from the original study cohort, potentially affecting score validity.

Purpose of the Study:

  • To establish contemporary normal Constant shoulder scores.
  • To compare these new values with Constant's original normative data.
  • To assess the impact of age and sex on shoulder scores in a modern population.

Main Methods:

  • Two groups were analyzed: 1620 clinic patients with normal shoulders and 115 healthy volunteers.
  • Scoring was performed by resident physicians (after instruction) and one experienced researcher.

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  • Statistical analysis compared scores between sexes, age groups, and with original Constant values.

    • Main Results:

    • No significant difference in scores was found between resident physicians and the experienced researcher, indicating reliable scoring after instruction.
    • Significant differences in scores were observed between sexes and age groups.
    • Age-related declines in shoulder scores and strength were noted but were less pronounced than in Constant's original study.
    • Calculating relative Constant scores using original values may overestimate shoulder function in women over 40 and men over 60.

    Conclusions:

    • Contemporary normal Constant shoulder scores differ from historical data.
    • The validity of relative Constant scores is questionable in specific demographic groups (older women, older men).
    • Reporting absolute Constant scores alongside relative scores is recommended for accurate population comparisons.