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Patients undergoing shoulder surgery have high preoperative expectations

  • SHOULDER
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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

IV.

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Funding

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

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Authors and Affiliations

  1. Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA

    Vidushan Nadarajah, Kali N. Stevens, Leah Henry, Julio J. Jauregui, Michael P. Smuda, Dominic J. Ventimiglia, Mohit N. Gilotra, S. Ashfaq Hasan & R. Frank Henn III

  2. Department of Orthopaedics, SUNY Downstate Medical Center, Brooklyn, NY, USA

    Vidushan Nadarajah

  3. University of Maryland Rehabilitation and Orthopaedic Institute, 2200 Kernan Drive, Baltimore, MD, 21207, USA

    R. Frank Henn III

Authors
  1. Vidushan Nadarajah
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  2. Kali N. Stevens
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  3. Leah Henry
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  9. R. Frank Henn III
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Correspondence to R. Frank Henn III.

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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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Nadarajah, V., Stevens, K.N., Henry, L. et al. Patients undergoing shoulder surgery have high preoperative expectations. Knee Surg Sports Traumatol Arthrosc 28, 2377–2385 (2020). https://doi.org/10.1007/s00167-019-05824-5

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  • DOI: https://doi.org/10.1007/s00167-019-05824-5

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