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CC BY-NC-ND 4.0 · Joints 2019; 07(04): 159-164
DOI: 10.1055/s-0041-1730982
Original Article

Prospective Comparative Study of Preoperative Expectations and Postoperative Outcomes in Anatomic and Reverse Shoulder Arthroplasty

Cassandra Lawrence
1   Department of Orthopaedic Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Mark Lazarus
2   Department of Orthopaedic Surgery, Rothman Institute–Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Joseph Abboud
2   Department of Orthopaedic Surgery, Rothman Institute–Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Gerald Williams
2   Department of Orthopaedic Surgery, Rothman Institute–Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Surena Namdari 
2   Department of Orthopaedic Surgery, Rothman Institute–Thomas Jefferson University, Philadelphia, Pennsylvania, United States
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Abstract

Background Compared with anatomic total shoulder arthroplasty (aTSA), reverse total shoulder arthroplasty (RTSA) is associated with lower preoperative and postoperative outcome scores and range of motion. It is unknown whether patients' preoperative expectations of surgery are lower in RTSA compared with aTSA. The purpose of this study was to assess preoperative patient expectations and postoperative outcomes in aTSA and RTSA.

Methods A consecutive series of patients undergoing primary aTSA for diagnosis of osteoarthritis or primary RTSA for diagnosis of rotator cuff tear arthropathy were studied prospectively. Expectations were evaluated using the validated Hospital for Special Surgery's Shoulder Surgery Expectations Survey. Baseline demographics, comorbidities, and social factors were collected. Baseline and 2 years postoperative American Shoulder and Elbow Surgeons (ASES) score, visual analog scale pain, Single Assessment Number Evaluation (SANE), and patient satisfaction were obtained.

Results There were 128 patients (64 aTSA and 64 RTSA). There was no significant difference in total preoperative expectations score between groups. On multivariate linear regression analysis, aTSA (p = 0.024) and younger age (p = 0.018) were associated with higher expectations for improved ability to exercise. Changes in preoperative to postoperative ASES (p = 0.004) and SANE (p = 0.001) scores were higher in the aTSA group. Total preoperative expectations score was not correlated with postoperative functional outcomes or satisfaction in either group. In the aTSA group, expectations for participation in exercise were positively correlated with changes in preoperative to postoperative ASES score (p = 0.01) and SANE score (p = 0.01).

Conclusion Though patients undergoing primary aTSA demonstrated greater improvement in functional outcome than those undergoing primary RTSA, both groups reported similar aggregate preoperative expectations. Those undergoing aTSA had higher expectations for return to exercise which was positively correlated with postoperative functional outcomes.

Level of Evidence Level II, prospective cohort study.

Keywords

expectations - reverse arthroplasty - total shoulder arthroplasty - exercise

Note

Investigation was performed at the Rothman Institute, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania.




Publication History

Received: 21 May 2019

Accepted: 18 April 2021

Article published online:
18 June 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Mancuso CA, Altchek DW, Craig EV. et al. Patients' expectations of shoulder surgery. J Shoulder Elbow Surg 2002; 11 (06) 541-549
    CrossrefPubMedSearch in Google Scholar
  • 2 Henn III RF, Kang L, Tashjian RZ, Green A. Patients' preoperative expectations predict the outcome of rotator cuff repair. J Bone Joint Surg Am 2007; 89 (09) 1913-1919
    CrossrefPubMedSearch in Google Scholar
  • 3 Mahomed NN, Liang MH, Cook EF. et al. The importance of patient expectations in predicting functional outcomes after total joint arthroplasty. J Rheumatol 2002; 29 (06) 1273-1279
    PubMedSearch in Google Scholar
  • 4 Henn III RF, Ghomrawi H, Rutledge JR, Mazumdar M, Mancuso CA, Marx RG. Preoperative patient expectations of total shoulder arthroplasty. J Bone Joint Surg Am 2011; 93 (22) 2110-2115
    CrossrefPubMedSearch in Google Scholar
  • 5 Flurin PH, Marczuk Y, Janout M, Wright TW, Zuckerman J, Roche CP. Comparison of outcomes using anatomic and reverse total shoulder arthroplasty. Bull Hosp Jt Dis (2013) 2013; 71 (Suppl. 02) 101-107
    PubMedSearch in Google Scholar
  • 6 Ponce BA, Oladeji LO, Rogers ME, Menendez ME. Comparative analysis of anatomic and reverse total shoulder arthroplasty: in-hospital outcomes and costs. J Shoulder Elbow Surg 2015; 24 (03) 460-467
    CrossrefPubMedSearch in Google Scholar
  • 7 Puskas B, Harreld K, Clark R, Downes K, Virani NA, Frankle M. Isometric strength, range of motion, and impairment before and after total and reverse shoulder arthroplasty. J Shoulder Elbow Surg 2013; 22 (07) 869-876
    CrossrefPubMedSearch in Google Scholar
  • 8 Swarup I, Henn CM, Nguyen JT. et al. Effect of pre-operative expectations on the outcomes following total shoulder arthroplasty. Bone Joint J 2017; 99-B (09) 1190-1196
    CrossrefPubMedSearch in Google Scholar
  • 9 Richards RR, An KN, Bigliani LU. et al. A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg 1994; 3 (06) 347-352
    CrossrefPubMedSearch in Google Scholar
  • 10 Williams GN, Gangel TJ, Arciero RA, Uhorchak JM, Taylor DC. Comparison of the Single Assessment Numeric Evaluation method and two shoulder rating scales. Outcomes measures after shoulder surgery. Am J Sports Med 1999; 27 (02) 214-221
    CrossrefPubMedSearch in Google Scholar
  • 11 Lippit SB, Harryman DT, Matsen FAI. A practical tool for evaluating function: the Simple Shoulder Test. In: Matsen FAI, Fu FH, Hawkins RJ. eds. The Shoulder: A Balance of Mobility and Stability. Rosemont, IL: American Academy of Orthopaedic Surgeons; 1993: 501-518
    Search in Google Scholar
  • 12 Selim AJ, Rogers W, Fleishman JA. et al. Updated U.S. population standard for the Veterans RAND 12-item Health Survey (VR-12). Qual Life Res 2009; 18 (01) 43-52
    CrossrefPubMedSearch in Google Scholar
  • 13 Rauck RC, Swarup I, Chang B. et al. Effect of preoperative patient expectations on outcomes after reverse total shoulder arthroplasty. J Shoulder Elbow Surg 2018; 27 (11) e323-e329
    CrossrefPubMedSearch in Google Scholar
  • 14 Rauck RC, Swarup I, Chang B. et al. Preoperative patient expectations of elective reverse shoulder arthroplasty. J Shoulder Elbow Surg 2019; 28 (07) 1217-1222
    CrossrefPubMedSearch in Google Scholar
  • 15 Jawa A, Dasti U, Brown A, Grannatt K, Miller S. Gender differences in expectations and outcomes for total shoulder arthroplasty: a prospective cohort study. J Shoulder Elbow Surg 2016; 25 (08) 1323-1327
    CrossrefPubMedSearch in Google Scholar
  • 16 Ollivier M, Frey S, Parratte S, Flecher X, Argenson JN. Pre-operative function, motivation and duration of symptoms predict sporting participation after total hip replacement. Bone Joint J 2014; 96-B (08) 1041-1046
    CrossrefPubMedSearch in Google Scholar
  • 17 Carroll LJ, Lis A, Weiser S, Torti J. How well do you expect to recover, and what does recovery mean, anyway? Qualitative study of expectations after a musculoskeletal injury. Phys Ther 2016; 96 (06) 797-807
    CrossrefPubMedSearch in Google Scholar
  • 18 Bible JE, Shau DN, Kay HF, Cheng JS, Aaronson OS, Devin CJ. Are low patient satisfaction scores always due to the provider? Determinants of patient satisfaction scores during spine clinic visits. Spine 2018; 43 (01) 58-64
    CrossrefPubMedSearch in Google Scholar
  • 19 Hageman MG, Briët JP, Bossen JK, Blok RD, Ring DC, Vranceanu AM. Do previsit expectations correlate with satisfaction of new patients presenting for evaluation with an orthopaedic surgical practice?. Clin Orthop Relat Res 2015; 473 (02) 716-721
    CrossrefPubMedSearch in Google Scholar
  • 20 Lawrence C, Zmistowski BM, Lazarus M, Abboud J, Williams G, Namdari S. Expectations of shoulder surgery are not altered by surgeon counseling of the patient. Joints 2017; 5 (03) 133-137
    Thieme ConnectPubMedSearch in Google Scholar