Our Summary

This research paper analyzed the outcomes and satisfaction of patients who have undergone a specific type of shoulder surgery - total shoulder arthroplasty (TSA), on both shoulders at different times. The study used data from April 2007 to October 2019 and included 60 patients who had undergone this procedure.

The study found that for most patients, the outcomes and satisfaction were similar for both shoulders, regardless of whether it was their dominant or non-dominant shoulder, and regardless of the order in which the surgeries were performed. However, there were some differences noted. For example, patients who had a specific type of TSA - the reverse TSA, reported more significant differences in function between their two shoulders after surgery. These patients were also more likely to report different levels of satisfaction with their two surgeries.

The researchers suggest that these findings could be useful for doctors when they are discussing expectations with their patients before surgery. However, they also note that it is unclear why these differences in outcomes and satisfaction occur.

FAQs

  1. What is the main focus of this research paper on shoulder replacement surgery?
  2. Did the study find any significant differences in patient outcomes and satisfaction based on the type of shoulder arthroplasty performed?
  3. Why do the researchers believe it’s important for doctors to discuss surgery expectations with their patients, and how can their findings assist in these discussions?

Doctor’s Tip

One helpful tip a doctor might tell a patient about shoulder replacement is to set realistic expectations for the outcome of the surgery. It is important for patients to understand that while most individuals experience improved function and pain relief after shoulder replacement, there may still be some differences in outcomes between the two shoulders, especially if a reverse TSA is performed. Additionally, patients should be aware that individual factors such as age, activity level, and overall health can also influence the success of the surgery. It is important for patients to communicate openly with their healthcare team about any concerns or questions they may have before and after the procedure.

Suitable For

Overall, patients who are recommended for shoulder replacement surgery typically have severe shoulder pain and dysfunction that is not adequately managed with conservative treatments such as physical therapy, medications, or injections. Common reasons for shoulder replacement include:

  1. Osteoarthritis: This is the most common reason for shoulder replacement surgery. Osteoarthritis is a degenerative joint disease that causes the cartilage in the shoulder joint to wear away, leading to pain, stiffness, and decreased range of motion.

  2. Rheumatoid arthritis: Patients with rheumatoid arthritis, an autoimmune disease that causes inflammation in the joints, may also benefit from shoulder replacement surgery to improve function and reduce pain.

  3. Rotator cuff tear arthropathy: This condition occurs when a massive rotator cuff tear leads to arthritis in the shoulder joint. Shoulder replacement surgery can help alleviate pain and restore function in these patients.

  4. Avascular necrosis: This condition occurs when the blood supply to the shoulder joint is disrupted, leading to bone death. Shoulder replacement may be recommended to relieve pain and improve function in patients with avascular necrosis.

  5. Post-traumatic arthritis: Patients who have sustained a severe shoulder injury, such as a fracture or dislocation, may develop post-traumatic arthritis over time. Shoulder replacement surgery can help improve function and alleviate pain in these cases.

  6. Failed previous shoulder surgery: In some cases, patients who have undergone previous shoulder surgeries that have failed to provide relief may be recommended for shoulder replacement to address ongoing pain and dysfunction.

Overall, patients who are considering shoulder replacement surgery should have a thorough evaluation by an orthopedic surgeon to determine if they are suitable candidates for the procedure. The decision to undergo shoulder replacement surgery should be made in collaboration with the patient’s healthcare team, taking into account the individual’s overall health, activity level, and goals for surgery.

Timeline

Before shoulder replacement surgery:

  1. Patient experiences chronic shoulder pain, stiffness, and limited range of motion.
  2. Patient undergoes a thorough evaluation by a healthcare provider to determine if shoulder replacement surgery is necessary.
  3. Patient participates in pre-operative appointments, tests, and physical therapy to prepare for surgery.
  4. Patient discusses the procedure, risks, benefits, and expected outcomes with their surgeon.

After shoulder replacement surgery:

  1. Patient undergoes the surgical procedure to replace the damaged shoulder joint with an artificial implant.
  2. Patient stays in the hospital for a few days for post-operative care and monitoring.
  3. Patient begins a rehabilitation program to regain strength, mobility, and function in the shoulder.
  4. Patient follows a post-operative care plan that includes pain management, physical therapy, and regular follow-up appointments with their healthcare provider.
  5. Patient gradually experiences improvement in shoulder function, reduced pain, and increased range of motion.
  6. Patient reaches a point of full recovery and is able to resume normal activities with minimal to no limitations.
  7. Patient reports satisfaction with the outcome of the surgery and improved quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about shoulder replacement surgery include:

  1. What type of shoulder replacement surgery do you recommend for me?
  2. What are the potential risks and complications associated with this surgery?
  3. What is the typical recovery time and rehabilitation process after shoulder replacement surgery?
  4. How long can I expect the shoulder replacement to last before needing a revision surgery?
  5. Will I experience any limitations in my range of motion or strength after the surgery?
  6. What are the expected outcomes and satisfaction rates for patients who have undergone this type of shoulder replacement surgery?
  7. Are there any specific factors or conditions that may affect my individual outcome and satisfaction with the surgery?
  8. What can I do to optimize my recovery and improve my chances of a successful outcome?
  9. Are there any alternative treatments or therapies that I should consider before opting for shoulder replacement surgery?
  10. How often will I need follow-up appointments with you after the surgery, and what signs or symptoms should I watch for that may indicate a complication?

Reference

Authors: Suttmiller AMB, Elwell JA, Roche C, Carofino BC. Journal: J Shoulder Elbow Surg. 2022 Sep;31(9):1789-1795. doi: 10.1016/j.jse.2022.02.014. Epub 2022 Mar 22. PMID: 35331855