Scientific Articles   |    
Preoperative Patient Expectations of Total Shoulder Arthroplasty
R. Frank Henn, III, MD; Hassan Ghomrawi, PhD; John R. Rutledge, MAS; Madhu Mazumdar, PhD; Carol A. Mancuso, MD; Robert G. Marx, MD
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Disclosure: One or more of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of an aspect of this work. In addition, one or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

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Department of Orthopaedics, University of Maryland School of Medicine, Kernan Hospital, 2200 Kernan Drive, Baltimore, MD 21207. E-mail address: Frank_Henn@yahoo.com
Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021
Investigation performed at the Hospital for Special Surgery, New York, NY

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2011 Nov 16;93(22):2110-2115. doi: 10.2106/JBJS.J.01114
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Very little data exist regarding patients’ preoperative expectations of the outcome of total shoulder arthroplasty. We hypothesized that younger patients and patients with worse function and worse general health would have greater expectations of total shoulder arthroplasty.


Ninety-eight patients who underwent unilateral primary total shoulder arthroplasty at one institution were studied prospectively. The preoperative evaluation included the American Shoulder and Elbow Surgeons (ASES) score, Shoulder Activity Scale, Short Form-36 (SF-36), and visual analog scale scores for shoulder pain, fatigue, and general health. Expectations were evaluated with use of the Hospital for Special Surgery's Shoulder Surgery Expectations Survey.


Relief of daytime pain, relief of nighttime pain, and improvement of shoulder range of motion were very important to 86%, 82%, and 84% of the patients, respectively. Expectations were not associated with education, history of previous joint replacement, or comorbidities. Greater expectations were associated with younger age, worse general health on the visual analog scale, and worse ASES scores (p < 0.05 for all), with correlation coefficients ranging from 0.25 to 0.28. Multivariate analysis showed that younger age was the only independent predictor of greater expectations (p < 0.05).


Younger patients had greater expectations of total shoulder arthroplasty, which may have implications for outcome and implant longevity.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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