Patients undergoing shoulder surgery have high preoperative expectations

  • Vidushan Nadarajah
  • Kali N. Stevens
  • Leah Henry
  • Julio J. Jauregui
  • Michael P. Smuda
  • Dominic J. Ventimiglia
  • Mohit N. Gilotra
  • S. Ashfaq Hasan
  • R. Frank HennIIIEmail author



The primary aims of this study were to (1) assess the preoperative expectations of patients undergoing shoulder surgery, and (2) determine the relationship between preoperative patient demographics, PROs, and preoperative patient expectations. It was hypothesized that younger patients with worse function and worse health status had higher expectations of shoulder surgery.


Data from a total of 319 patients (319 shoulders) from 2015–2018 were analyzed. Patients completed a series of questionnaires covering demographics and patient-reported outcome measures. Expectations of treatment were evaluated using the Musculoskeletal Outcomes Data Evaluation and Management System. Bivariate analyses were performed to determine the significance of identified associations.


The study population consisted of 186 males and 133 females. The mean age was 46.9 (± 17.2), and the mean BMI was 30.1 (± 6.8). Overall, patients had high expectations of shoulder surgery, with a mean score of 84.7 (± 19.3). The most commonly performed procedure in the study population was arthroscopic rotator cuff repair. There was a significant association between pre-treatment expectations and ethnicity, previous shoulder surgery, employment status, income level, tobacco use, preoperative opioid use, depression, and ASA score.


The findings suggest that patients undergoing shoulder surgery have high overall preoperative expectations, which were significantly associated with ethnicity, surgical history, opioid use, and employment status, and with multiple patient-reported outcome measures including physical function, pain interference, fatigue, and depression. Nevertheless, by discussing expectations preoperatively, orthopaedic surgeons can help patients develop high but realistic expectations to improve outcomes and satisfaction.

Level of evidence



PROMIS Patient expectations Shoulder surgery Patient outcomes 



This work was supported by a grant from The James Lawrence Kernan Hospital Endowment Fund, Incorporated.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

This study was approved by the Institutional Review Board (IRB) at the University of Maryland, Baltimore (HP-00062261).


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020

Authors and Affiliations

  • Vidushan Nadarajah
    • 1
    • 2
  • Kali N. Stevens
    • 1
  • Leah Henry
    • 1
  • Julio J. Jauregui
    • 1
  • Michael P. Smuda
    • 1
  • Dominic J. Ventimiglia
    • 1
  • Mohit N. Gilotra
    • 1
  • S. Ashfaq Hasan
    • 1
  • R. Frank HennIII
    • 1
    • 3
    Email author
  1. 1.Department of OrthopaedicsUniversity of Maryland School of MedicineBaltimoreUSA
  2. 2.Department of OrthopaedicsSUNY Downstate Medical CenterBrooklynUSA
  3. 3.University of Maryland Rehabilitation and Orthopaedic InstituteBaltimoreUSA

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