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Total Shoulder Replacement – Long Term Follow Up with the Constant Score

Research - Long Term Projects

Total Shoulder Replacement – Long Term Follow Up with the Constant Score


Total shoulder replacement* has become a mainstay for several painful shoulder conditions when non-operative treatments fail and in the majority of cases, the surgery provides predictable pain relief, mobility and functional improvement with satisfactory longevity.

Patient satisfaction, however, has been seen to fall short immediately following the surgery but improve with time. With this study, we wish to see how outcomes vary both in the short and long term and improve upon the paucity of long term data both locally and globally.

The Constant Score^ is a widely used shoulder-specific scoring system. Devised by Christopher Constant in 1987, this functional assessment score was conceived as a system of assessing the overall value, or functional state, of a normal, diseased or treated shoulder. In 1992, the European Shoulder and Elbow Society mandated the use of the Constant Score in all peer-reviewed papers, making it the most widely used shoulder evaluation instrument in Europe (and around the world). It is reliable and reproducible, providing a subjective and objective measure of patient symptoms and strength. It also provides an important measure for patient follow up and has the potential to highlight specific patient concerns.


The objective of this study is to evaluate the long term subjective and objective outcomes in patients undergoing total shoulder replacement using the Constant Score.


This is a prospective observational study.

Study Procedure

All participants meeting inclusion criteria will be administered the Constant Score pre-operatively and then post-operatively each year from 1 to 10 years.

Inclusion Criteria

  • Patients undergoing total shoulder replacement surgery
  • Willingness to give written informed consent and willingness to participate in and comply with the Study

Exclusion Criteria

  • Patients undergoing total shoulder replacement surgery as a result of trauma eg fracture


Participants are at various stages of data collection. Earliest recruits have reached the 4 year post-operative follow up mark.


  • Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 1987 Jan;(214)(214):160-164.
  • Johansson KM, Adolfsson LE. Intraobserver and interobserver reliability for the strength test in the Constant-Murley shoulder assessment. J Shoulder Elbow Surg 2005 May-Jun;14(3):273-278.
  • Kuhlman JR, Iannotti JP, Kelly MJ, Riegler FX, Gevaert ML, Ergin TM. Isokinetic and isometric measurement of strength of external rotation and abduction of the shoulder. J Bone Joint Surg Am 1992 Oct;74(9):1320-1333.
  • Levy O, Haddo O, Massoud S, Mullett H, Atoun E. A patient-derived Constant-Murley score is comparable to a clinician-derived score. Clin Orthop Relat Res 2014 Jan;472(1):294-303.
  • Moseley HF. Examination of the shoulder. Shoulder lesions. 3rd ed. Edinburgh: Churchill Livingstone; 1969. p. 20-30.
  • Deshmukh AV, Koris M, Zurakowski D and Thornhill TS. Total shoulder arthroplasty: Long-term survivorship, functional outcome, and quality of life. J Shoulder Elbow Surg 2005 May-Jun;14:471-479.

* Learn more about Total Shoulder Replacement

^ Learn more about the Constant Score


Lead Investigator:

Dr Allan Young




Participants are at various stages of data collection.


– Long Term Projects

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Retrospective Review of the use of the Rota-Lok system for massive rotator cuff repairs

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Early mobilisation following rotator cuff repair

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Propionibacterium acnes contamination in shoulder surgery

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Modified Biceps Repair

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Improving medial footprint coverage in double row cuff repair using FiberTape

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Rate of P Acnes in arthritic shoulders undergoing primary total shoulder replacement surgery using a strict specimen collection technique

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Comparative study of physician applied and patient reported Constant Scores utilising bathroom scales to derive force measurements

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The VAULT Study - Glenoid Version Measurement

The VAULT Study – Glenoid Version Measurement

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The FUSE Study (Fitness band Used in Shoulder Evaluation)

The FUSE Study – Fitness band Used in Shoulder Evaluation

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Precision and Accuracy of Pumps used in Shoulder Arthroplasty

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TXA Study (Systemic Tranexamic Acid in Shoulder Arthroplasty

The TXA Study (Systemic Tranexamic Acid in Shoulder Arthroplasty)

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The TXA 2 Study (Systemic Tranexamic Acid in Shoulder Arthroscopy and Rotator Cuff Repair)

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