PURPOSE: athletes affected by shoulder instability cannot be judged solely according to the criteria used for non-athletes. In order to improve the assessment of shoulder instability surgery outcomes, the SPORTS score was tested in a cohort of athletes. METHODS: ninety-eight athletes at an average follow-up of 4.6 years (range 1-9.2) after open or arthroscopic surgery for recurrent anterior shoulder instability were included in this study. The patients were asked to complete the SPORTS score questionnaire twice, with an interval of 2-3 weeks between the two assessments. The Bland-Altman method and the intra-class correlation coefficient were used to measure reliability. Criterion validity was assessed by calculating the Spearman correlation coefficient between the SPORTS score and the Western Ontario Shoulder Instability Index (WOSI) score, the Rowe score, the Oxford Shoulder Instability Score (OSIS), and the Subjective Shoulder Value (SSV). RESULTS: the SPORTS score showed excellent test-retest reliability. The systematic error between the first and the second assessment was 0.3 points (95% upper limit of agreement = 2.3 points). The criterion validity was found to be strong for the SPORTS score, which correlated best with the SSV and the "sport, recreation, and work" component of the WOSI score. The SPORTS score had an acceptable floor effect (8%). The ceiling effect was 46%, which was better than the ceiling effects seen with the Rowe, OSIS and WOSI scores. CONCLUSIONS: this study suggests that the SPORTS score is a valid score in the assessment of athletes after surgery for shoulder instability and that it adds important information to the currently available scores. LEVEL OF EVIDENCE: Level III, diagnostic study of nonconsecutive patients.
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