Our Summary

This research paper analyzes how often randomized controlled trials (RCTs) related to shoulder replacement surgery are properly registered and reported, as recommended by the Journal of Shoulder and Elbow Surgery (JSES). The researchers looked at RCTs from 2010 to 2022 and found that less than half of these trials were registered. Out of those registered, more than 30% had at least one difference between the results reported in the trial registry and in the final publication. This discrepancy often related to when the trial assessment was carried out. The researchers concluded that there’s a need for better review of trial registration and reporting to prevent bias in these studies.

FAQs

  1. What was the purpose of this research study on randomized controlled trials related to shoulder replacement surgery?
  2. What discrepancies were found between the trial registry and the final publication of the shoulder replacement studies?
  3. Based on the research, what recommendations were made to improve the registration and reporting of shoulder replacement surgery trials?

Doctor’s Tip

A doctor might tell a patient considering shoulder replacement surgery to make sure they fully understand the procedure, including the risks and benefits, and to ask their surgeon about the specific approach they will be using and what their expected recovery timeline looks like. It’s also important for patients to follow their post-operative care instructions closely and attend all follow-up appointments to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for shoulder replacement surgery are those who have severe shoulder pain and stiffness that limits their ability to perform daily activities, such as dressing, bathing, and reaching overhead. These patients may have tried other treatments, such as physical therapy, medications, and cortisone injections, without success. Additionally, patients with shoulder arthritis, rotator cuff tears, or other shoulder injuries that have not responded to conservative treatment may also be candidates for shoulder replacement surgery. It is important for patients to consult with a healthcare provider to determine if shoulder replacement surgery is the right treatment option for their specific condition.

Timeline

Before shoulder replacement surgery, a patient typically experiences chronic shoulder pain, limited range of motion, stiffness, weakness, and difficulty performing daily activities. They may have tried non-surgical treatments such as physical therapy, medications, injections, and other interventions without success. After a consultation with an orthopedic surgeon, the patient undergoes pre-operative evaluations, imaging tests, and discussions about the procedure, risks, and expected outcomes.

During shoulder replacement surgery, the damaged or arthritic parts of the shoulder joint are removed and replaced with artificial components made of metal, plastic, or ceramic. The surgery can be performed using different techniques such as total shoulder replacement, partial shoulder replacement, or reverse shoulder replacement, depending on the patient’s condition and needs.

After shoulder replacement surgery, the patient goes through a period of recovery and rehabilitation. They may experience pain, swelling, stiffness, and limited mobility in the shoulder initially. Physical therapy and exercises are prescribed to help regain strength, flexibility, and function in the shoulder. Follow-up appointments with the surgeon are scheduled to monitor the healing process and address any concerns or complications.

Over time, the patient typically experiences improvements in shoulder function, reduced pain, and increased quality of life. They are able to resume activities they couldn’t do before the surgery and enjoy a better overall shoulder function. It’s important for patients to follow their surgeon’s instructions, attend rehabilitation sessions, and maintain a healthy lifestyle to optimize the long-term outcomes of shoulder replacement surgery.

What to Ask Your Doctor

  1. What are the different types of shoulder replacement surgeries available and which one is recommended for my specific condition?
  2. What are the potential risks and complications associated with shoulder replacement surgery?
  3. What is the expected recovery time and rehabilitation process after shoulder replacement surgery?
  4. How long can I expect the shoulder replacement to last and what factors can affect its longevity?
  5. Are there any alternative treatments or therapies that could be considered before opting for shoulder replacement surgery?
  6. How experienced is the surgical team in performing shoulder replacement surgeries?
  7. What are the outcomes and success rates for shoulder replacement surgery in patients with similar conditions?
  8. What type of post-operative pain management and follow-up care will be provided?
  9. Are there any specific lifestyle changes or precautions I should take after the surgery to ensure optimal outcomes?
  10. Are there any restrictions or limitations in terms of physical activities or movements after shoulder replacement surgery?

Reference

Authors: Imam N, Sudah SY, Bonney AA, Hahn AK, Manzi JE, Nicholson AD, Menendez ME. Journal: J Shoulder Elbow Surg. 2023 Sep;32(9):1763-1769. doi: 10.1016/j.jse.2023.04.004. Epub 2023 May 22. PMID: 37224915