Friday, January 17, 2020

Shoulder arthroplasty - selecting the right patient - the 4 Ps

Psychosocial factors affecting outcomes after shoulder arthroplasty: a systematic review

These authors conducted a review of sixteen article located using keywords ‘‘shoulder arthroplasty outcomes,’’ ‘‘psychosocial factors shoulder,’’ ‘‘shoulder replacement outcomes,’’ ‘‘depression shoulder arthroplasty,’’ ‘‘satisfaction shoulder arthroplasty,’’ ‘‘factors shoulder replacement,’’ ‘‘expectations shoulder arthroplasty,’’ and ‘‘predictors shoulder arthroplasty.’’

Six reviewed mental health disorders as predictors of postoperative outcome after shoulder arthroplasty. Of these, 4 found that disorders such a depression and anxiety were associated with increased risk of perioperative complications and lower final functional outcome scores. Two studies evaluated workers’ compensation status as a possible predictor of outcomes and found that patients with claims had lower satisfaction and outcome scores at final follow-up compared with those without claims. Two studies showed that preoperative opioid use was associated with lower outcome scores and overall satisfaction rate after shoulder arthroplasty. 





Three studies showed that higher patient confidence and preoperative expectations were correlated with better outcomes.

Comment: We like to point out that the outcome of shoulder arthroplasty, or any treatment for that matter, depends on for independent factors, the 4 Ps: the problem being treated, the procedure used to treat the problem, the physician rendering the treatment, and the patient reiving the treatment. This study calls our attention to the importance of the last P, the patient. Best results can be obtained by optimizing all four!

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To see a YouTube of our technique for total shoulder arthroplasty, click on this link.

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To see our new series of youtube videos on important shoulder surgeries and how they are done, click here.

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