Patient expectations before arthroscopic shoulder surgery: correlation with patients’ reasons for seeking treatment

Background Elevated expectations before orthopaedic procedures appear to correlate with inferior preoperative subjective measures. The purpose of this study was to evaluate preoperative patient expectations before arthroscopic shoulder surgery and to correlate them with preoperative subjective measu...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2013-12, Vol.22 (12), p.1676-1681
Main Authors: Warth, Ryan J., MD, Briggs, Karen K., MPH, Dornan, Grant J., MSc, Horan, Marilee P., MPH, Millett, Peter J., MD, MSc
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
arthroscopy
Arthroscopy - psychology
Cross-Sectional Studies
expectations
Female
Humans
Joint Diseases - psychology
Joint Diseases - surgery
Male
Middle Aged
Orthopedics
outcomes
Patient Acceptance of Health Care - psychology
Patient Satisfaction
preoperative
Preoperative Period
Recovery of Function
Retrospective Studies
Shoulder
Shoulder Joint - surgery
Sports
Surveys and Questionnaires
Treatment Outcome
Young Adult
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Summary:Background Elevated expectations before orthopaedic procedures appear to correlate with inferior preoperative subjective measures. The purpose of this study was to evaluate preoperative patient expectations before arthroscopic shoulder surgery and to correlate them with preoperative subjective measures and patients’ reasons for seeking treatment. Methods We prospectively collected and retrospectively analyzed data from patients before elective arthroscopic shoulder surgery for a wide range of pathologic processes. Preoperative subjective data included QuickDASH scores, pain and functional components of the American Shoulder and Elbow Surgeons (ASES) score, and mental and physical components of the SF-12 score. Expectations data were collected and grouped on the basis of the reasons for seeking of medical treatment and ranked according to their relative importance. Results The study included 313 shoulders. There were 205 men and 108 women with a mean age at surgery of 48.7 years (range, 18-78 years). Overall, the most important expectations were for the “shoulder to be back to the way it was before the problem started” and to continue participation in sporting activities. Patients who presented with the “shoulder coming out” had fewer important expectations than did those who presented for other reasons. Those patients who indicated a desire to continue participation in sports had significantly less pain (improved ASES pain scores) compared with the rest of the population. Conclusions Although return to sport was the most important expectation overall, the importance of other expectations varied by patients’ reasons for seeking treatment. The current questionnaire may have limited use in patients with shoulder instability.
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2013.05.003