Optimal screening for prediction of referral and outcome score is a strong predictor of shoulder pain and function in glenohumeral osteoarthritis and rotator cuff arthropathy

JSES Int. 2026 Jan 28;10(3):101637. doi: 10.1016/j.jseint.2026.101637. eCollection 2026 May.

ABSTRACT

BACKGROUND: Mental health has been shown to be a risk factor for having significant impacts on pain and function in patients with shoulder pathology. The aims of this study are to (1) evaluate the overall impact of psychological distress on pain perception and shoulder function in patients with glenohumeral osteoarthritis (GHOA) and rotator cuff arthropathy (RCA) and (2) determine whether there is a difference in pain, function, or psychological distress between patients with differing severity of GHOA vs. RCA.

METHODS: A retrospective review of patients diagnosed with GHOA or RCA who completed the Optimal Screening for Prediction of Referral and Outcome-Yellow Flag (OSPRO-YF) score between September 2022 and January 2025 was performed. The OSPRO-YF score was categorized by negative mood, negative coping, and positive coping domains. Demographic, diagnosis, Walch glenoid type, Hamada grade of RCA, and 3 preoperative patient-reported outcomes (PROs) scores: Single Assessment Numeric Evaluation (SANE), visual analog scale (VAS), and American Shoulder and Elbow Surgeons (ASES) scores were obtained. A Student's T-test and analysis of variance was used to analyze the cohorts and a linear regression analysis was used to evaluate the association between the OSPRO-YF and PRO scores while adjusting for the diagnosis and severity of GHOA and RCA.

RESULTS: There were 62 patients with GHOA and 30 patients with RCA. There was a significant difference in ASES scores in patients with differing glenoid erosions. However, there were no significant differences in age, body mass index, smoking, VAS, SANE, or OSPRO-YF scores between cohorts, type of glenoid erosion, or severity of RCA. Psychological distress, measured via the OSPRO-YF tool, revealed notable associations with PRO scores. Total OSPRO-YF scores demonstrated a significant association across all PRO scores including VAS (P = .003), SANE (P = .006), and ASES (P = .00) scores. Depression was strongly associated with ASES scores (P = .007). Fear avoidance behaviors had significant correlations across all PRO scores. Pain anxiety was associated with VAS pain and ASES scores, while pain catastrophizing was associated with SANE scores.

CONCLUSION: These findings suggest preoperative psychological distress and maladaptive coping mechanisms have a significant influence on patient's shoulder pain and function. Negative coping behaviors are associated with worse pain and function in patients with either GHOA or RCA. Thus, the OSPRO-YF score may be utilized to predict patients with lower functional scores and support the importance of routine preoperative psychological evaluation, which may impact a patient's overall postoperative care and recovery.

PMID:41815875 | PMC:PMC12972953 | DOI:10.1016/j.jseint.2026.101637