Utility of total shoulder, reverse total shoulder, and revision shoulder arthroplasty

Isometric strength, range of motion, and impairment before and after total and reverse shoulder arthroplasty

How effective are our attempts at shoulder reconstruction in lessening the disabilities experienced by our patients?

This is an interesting study that examines the disease severity and subsequent improvement from primary total shoulder (TSA), primary reverse total shoulder ( RSA), and revision arthroplasty (TSA and RSA).

174 shoulders (87 primary TSA, 55 primary RSA, and 32 revision cases) were prospectively studied using Biodex isometric strength and standardized video range of motion measurements at 1 week before surgery and at an average of 49 months (range, 32-69 months) postoperatively. Patient impairment ratings were calculated by an independent evaluator using the Florida Impairment Guidelines.

As shown in the figure below, primary TSA had the lowest average preoperative impairment and revision arthroplasty had the highest. All patients demonstrated improvement in impairment ratings.

We can anticipate that payers of healthcare will be increasingly interested in the return on their investments in what we do. These authors have provided a robust approach for documenting the effectiveness of their surgeries.

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