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Knee Surgery, Sports Traumatology, Arthroscopy

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01-01-2018 | Shoulder

Patients’ expectations of shoulder instability repair

Authors: Johannes E. Plath, Tim Saier, Matthias J. Feucht, Philipp Minzlaff, Gernot Seppel, Sepp Braun, Daniel Hatch, Andreas B. Imhoff

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2018

Abstract

Purpose

To analyze and compare patient expectations of primary and revision shoulder stabilization and to assess the factors associated with patients’ expectations.

Methods

Pre-operative patient expectations after shoulder instability repair were prospectively assessed using a self-designed questionnaire. The survey included questions on the expected level and type of return to sports, instability, pain, risk of osteoarthritis, and overall shoulder condition.

Results

One-hundred and forty-five patients (99 primary; 46 revision repair) were included. A return to sport at the same level with slight to no restrictions was expected in 95%, a return to high-risk activities in 34%, to moderate in 58%, and to low-risk activities in 9%. No pain [instability] independent of the activity level was expected by 71% [79%] and occasional pain [instability] during contact and overhead activities by 25% [19%]. 61% expected to have no risk of glenohumeral osteoarthritis, 37% a slight, and 2% a significant risk. The overall expectation for the post-operative shoulder was indicated to be normal or nearly normal in 99% of patients. The revision group did not differ from the primary repair group in any variable. High pre-operative sport performance was positively correlated with post-operative sport expectations. The number of dislocations, the duration of instability, and the subjective instability level were negatively correlated with return to sport expectations.

Conclusion

Patient expectations for primary and revision shoulder instability repair are high. Realistic patient expectations regarding the surgical procedure are necessary to avoid low patient satisfaction, especially in pre-operatively highly active and demanding athletes. The surgeon must not solely base the treatment on the pathology and possible risk factors for failure but should also take the individual expectation of the patient into account.

Level of evidence

III.

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Title: Patients’ expectations of shoulder instability repair
Authors: Johannes E. Plath
Tim Saier
Matthias J. Feucht
Philipp Minzlaff
Gernot Seppel
Sepp Braun
Daniel Hatch
Andreas B. Imhoff
Publication date: 01-01-2018
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-017-4489-7

At a glance: The STEP trials

Springer Medicine

Patients’ expectations of shoulder instability repair

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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