Ryan C Rauck1, Ishaan Swarup2, Brenda Chang2, David M Dines2, Russell F Warren2, Lawrence V Gulotta2, R Frank Henn3. 1. Department of Orthopaedics, Hospital for Special Surgery, New York, NY, USA. Electronic address: rauckr@hss.edu. 2. Department of Orthopaedics, Hospital for Special Surgery, New York, NY, USA. 3. Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA.
Abstract
BACKGROUND: The purpose of this study was to determine the effect of preoperative expectations on outcomes after reverse shoulder arthroplasty (RSA). We hypothesized that patients with greater expectations would have better outcomes. METHODS: Patients undergoing primary RSA completed the Hospital for Special Surgery's Shoulder Expectations Survey preoperatively. Preoperative and 2-year postoperative clinical outcomes were measured with the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form, Shoulder Activity Scale (SAS), 36-Item Short Form Health Survey (SF-36), and visual analog scales (VASs). Pearson correlations were used to assess the relationship between the number of expectations and outcomes. Differences in outcomes between those with higher and lower levels of expectations for each expectation question were assessed by independent samples t test. Multivariable linear regression analysis was used to control for potential confounding factors. RESULTS: We evaluated 135 patients at 2 years postoperatively. Patients had higher expectations for relieving pain, improving self-care, improving ability to perform daily activities, and improving ability to drive or put on a seatbelt. Patients with a greater number of high expectations preoperatively did not have better ASES, SAS, or VAS pain scores postoperatively. However, higher expectations for relieving nighttime pain was associated with ASES (β = 7.0, P = .048) and VAS pain scores (β = -5.9, P = .047) as well as 2-year improvement of VAS pain (β = -6.1, P = .039). Higher expectations for improving the ability to participate in nonoverhead sports was associated with improvements in SAS (β = 2.8, P = .020). CONCLUSION: A higher level of expectations for relief of nighttime pain and improving ability to participate in nonoverhead sports is associated with improved outcomes after RSA.
BACKGROUND: The purpose of this study was to determine the effect of preoperative expectations on outcomes after reverse shoulder arthroplasty (RSA). We hypothesized that patients with greater expectations would have better outcomes. METHODS:Patients undergoing primary RSA completed the Hospital for Special Surgery's Shoulder Expectations Survey preoperatively. Preoperative and 2-year postoperative clinical outcomes were measured with the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form, Shoulder Activity Scale (SAS), 36-Item Short Form Health Survey (SF-36), and visual analog scales (VASs). Pearson correlations were used to assess the relationship between the number of expectations and outcomes. Differences in outcomes between those with higher and lower levels of expectations for each expectation question were assessed by independent samples t test. Multivariable linear regression analysis was used to control for potential confounding factors. RESULTS: We evaluated 135 patients at 2 years postoperatively. Patients had higher expectations for relieving pain, improving self-care, improving ability to perform daily activities, and improving ability to drive or put on a seatbelt. Patients with a greater number of high expectations preoperatively did not have better ASES, SAS, or VAS pain scores postoperatively. However, higher expectations for relieving nighttime pain was associated with ASES (β = 7.0, P = .048) and VAS pain scores (β = -5.9, P = .047) as well as 2-year improvement of VAS pain (β = -6.1, P = .039). Higher expectations for improving the ability to participate in nonoverhead sports was associated with improvements in SAS (β = 2.8, P = .020). CONCLUSION: A higher level of expectations for relief of nighttime pain and improving ability to participate in nonoverhead sports is associated with improved outcomes after RSA.
Authors: Samir Kaveeshwar; Kali N Stevens; Dominic J Ventimiglia; Tina Zhang; Matheus B Schneider; Leah E Henry; S Ashfaq Hasan; Mohit N Gilotra; R Henn Frank Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-07-03 Impact factor: 4.342
Authors: Paul B McLendon; Kaitlyn N Christmas; Peter Simon; Otho R Plummer; Audrey Hunt; Adil S Ahmed; Mark A Mighell; Mark A Frankle Journal: JB JS Open Access Date: 2021-03-26
Authors: Robert Z Tashjian; Bradley Hillyard; Victoria Childress; Jun Kawakami; Angela P Presson; Chong Zhang; Peter N Chalmers Journal: J Shoulder Elbow Surg Date: 2020-06-09 Impact factor: 3.019