CORR Insights^®: Patients Undergoing Total Shoulder Arthroplasty on the Dominant Extremity Attain Greater Postoperative ROM

Excerpt

The current study by Cvetanovich and colleagues, which focuses on the effect that hand dominance has on the outcome of total shoulder arthroplasty, is interesting not so much for what it documents, but more so for what it implies. This is a well-controlled study in which the demographics and preoperative ROM were identical. Beyond that, it is a single-surgeon study using the same appliance in all cases with the uniform diagnosis of osteoarthritis, and presumably, identical physical therapy orders. With that background, it seems that the question should not be: “Is there a difference in outcome between dominant versus nondominant shoulder following total shoulder arthroplasty?” Instead, we should ask: “Why would there be any difference?” The authors go on to suggest that this information could be useful in terms of preoperative “patient counseling concerning the expected outcome.” Is that a good idea? I believe the answer to these queries might best be found in the book Outliers by Malcolm Gladwell [2] and in Aesop’s fables [1] rather than the medical literature. …