Effect of preoperative patient expectations on outcomes after reverse total shoulder arthroplasty
Publication Date
2018
Journal Title
J Shoulder Elbow Surg
Abstract
© 2018 Journal of Shoulder and Elbow Surgery Board of Trustees 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.
Volume Number
27
Issue Number
11
Pages
e323 - e329
Document Type
Article
Status
Faculty
Facility
School of Medicine
Primary Department
Orthopedic Surgery
PMID
DOI
10.1016/j.jse.2018.05.026