Friday, May 17, 2019

Shoulder joint replacement for arthritis - how long does it take to get better?

Correlation of multiple patient-reported outcome measures across follow-up in patients undergoing primary shoulder arthroplasty 

The Simple Shoulder Test (SST) is a short, easy to complete questionnaire that enables a patient to describe  the comfort and function of the shoulder.

These authors used the SST and some other patient reported outcome questionnaires to document the recovery of shoulders having anatomic and reverse total shoulders for arthritis.

Here is the result for the SST, showing the typical outcomes for these procedures.





They noted that multiple validated outcome scores have been used to assess patients undergoing shoulder arthroplasty. They sought to determine whether a correlation exists between 3 commonly used patient-reported outcome (PRO) measures in this population: Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Assessment Form, and Simple Shoulder Test (SST).

They performed a retrospective review of a shoulder arthroplasty database that routinely collects SPADI, ASES, and SST scores at each visit prospectively. Patients undergoing primary shoulder arthroplasty were identified. Assessments of correlation coefficients (Pearson correlation coefficient for ASES and SPADI scores and Spearman correlation coefficient for SST score) between each combination of PROs were performed overall and at each time point (preoperatively and 3, 6, 12, and 24 months postoperatively) to determine the level of association between PROs.

In total, 848 shoulder arthroplasty procedures were performed in 754 patients with 2796 unique clinical encounters. Preoperative correlations among PROs were moderate to strong (range, 0.66-0.77) but had the lowest correlation among all comparisons. Postoperative correlations were strong for all PRO comparisons (range, 0.73-0.94). Postoperative PRO correlations continued to strengthen over longer follow-up, with all values exceeding 0.78 at 2 years postoperatively. Conversion equations between PROs were calculated based on these highly correlated data.

They concluded that after primary shoulder arthroplasty, there exists a high degree of correlation among all 3 studied PROs.

Comment: This study demonstrates the comparability of patient self-assessments of shoulder comfort and function. It shows that a simple questionnaire, such as the SST, can provide the same quality of information as more lengthy more complex approaches

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We have a new set of shoulder youtubes about the shoulder, check them out at this link.

Be sure to visit "Ream and Run - the state of the art" regarding this radically conservative approach to shoulder arthritis at this link and this link

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