Isokinetic strength differences between patients with primary reverse and total shoulder prostheses

Alta, T.D.W.; Veeger, H.E.J.; Toledo, Joelly Mahnic de; Janssen, Thomas W J; Willems, W. Jaap

doi:10.1016/j.clinbiomech.2014.08.018

Cited by 21 publications

(10 citation statements)

References 35 publications

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“…Previous studies have also reported that patients with greater isokinetic shoulder strength participate in higher-demand recreational or sports activity and report fewer difficulties with activities of daily living 20 . Conversely, patients with lower isokinetic shoulder strength were reported to be more likely to have reduced range of motion 1 and also associated inferior clinical outcomes after RTSA 1 . Our study found little correlation between shoulder strength assessed clinically with PROs.…”

Section: Discussioncontrasting

confidence: 66%

“…Patients experience improved function and outcomes after RTSA for conditions such as cuff tear arthropathy and glenohumeral arthritis in the setting of rotator cuff pathology 3, 6, 15. The improvement in patient satisfaction has been correlated with functional recovery and resumption of regular activities 1, 4, 20, 22, 23. To better measure and assess such patient outcomes after surgery, patient-reported outcomes (PROs) scores have become increasingly used in total joint arthroplasty and shoulder surgery 8, 9, 12, 23…”

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confidence: 99%

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Clinical measurements versus patient-reported outcomes: analysis of the American Shoulder and Elbow Surgeons physician assessment in patients undergoing reverse total shoulder arthroplasty

et al. 2018

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BackgroundThe American Shoulder and Elbow Surgeons (ASES) score is composed of a patient-reported portion and a physician assessment. Although the patient-reported score is frequently used to assess postoperative outcomes after shoulder arthroplasty, no previous studies have used the physician-assessment component. This study evaluated the relationship of the ASES physician-assessment measurements with patient-reported shoulder and general health outcomes.MethodsA retrospective review of a prospectively collected multicenter database was used to analyze patients who underwent primary reverse total shoulder arthroplasty (RTSA) from 2012 to 2015 with a minimum 2-year follow-up. ASES physician-assessment and patient-reported components and 12-Item Short Form Health Survey (SF-12) general health questionnaires were obtained preoperatively and 2 years postoperatively. The relationship between ASES physician measurements with ASES patient-reported outcome (PRO) scores and SF-12 Physical and Mental domain scores was assessed with Pearson correlation coefficients.ResultsIncluded were 74 patients (32 men; mean age, 69.2 years; body mass index, 29.4 kg/m2). Preoperative physician measurements and PRO scores were not significantly correlated. Postoperatively, only the ASES physician-measured active (R = 0.54, P < .01) and passive forward flexion (R = 0.53, P < .01) demonstrated moderate correlation with ASES patient scores. The remaining clinical measurements had no significant correlations with ASES patient or SF-12 scores. During the 2-year period, only improvements in active forward flexion correlated with improvements in ASES patient scores (R = 0.36, P < .01).ConclusionsLittle correlation exists between clinical measurements from the ASES physician component and PROs, including the ASES patient-reported and SF-12 general health surveys, in RTSA patients. Improvement in active forward flexion is the only clinical measurement correlated with PRO improvement at 2 years.

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Section: Discussioncontrasting

confidence: 66%

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confidence: 99%

Clinical measurements versus patient-reported outcomes: analysis of the American Shoulder and Elbow Surgeons physician assessment in patients undergoing reverse total shoulder arthroplasty

et al. 2018

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“…Consistent with these findings, in our study, TSA patients demonstrated a significantly higher ability to participate in their usual sports without difficulty (ASES-specific score of 3). This observation may relate to lower ultimate achievements in range of motion and strength in patients treated with RSA, when compared with TSA patients, 24,25 and the generalized practice of utilizing RSA for lower-demand patients (RSA patients in this study were older).…”

Section: Discussionmentioning

confidence: 84%

Participation in Work and Sport Following Reverse and Total Shoulder Arthroplasty

Kurowicki

Rosas²,

Law³

et al. 2018

Am J Orthop

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Both anatomical total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA) are routinely performed for patients who desire to continuously work or participate in sports. This study analyzes and compares the ability of patients to work and partake in sports following shoulder arthroplasty based on responses to clinical outcome surveys. A retrospective review of the shoulder surgery repository was performed for all patients treated with TSA and RSA and who completed questions 9 and 10 on the activity patient self-evaluation portion of the American Shoulder and Elbow Surgeons (ASES) Assessment Form. Patients with a minimum of 1-year follow-up were included if a sport or work was identified. The analysis included 162 patients with TSA and 114 patients with RSA. Comparisons were made between TSA and RSA in terms of the specific ASES scores (rated 0-3) reported for ability to work and participate in sports and total ASES scores, and scores based on specific sports or line of work reported. Comparisons were also made between sports predominantly using shoulder function and those that do not. TSA patients had a 27% higher ability to participate in sports (average specific ASES score: 2.5 vs 1.9, P < .001) than RSA patients and presented significantly higher scores for swimming and golf. Compared with RSA patients, TSA patients demonstrated more ability to participate in sports requiring shoulder function without difficulty, as 63% reported maximal scores (P = .003). Total shoulder arthroplasty patients also demonstrated a 21% higher ability to work than RSA patients (average specific ASES scores: 2.6 vs 2.1, P < .001), yielding significantly higher scores for housework and gardening. Both TSA and RSA allow for participation in work and sports, with TSA patients reporting better overall ability to participate. For sports involving shoulder function, TSA patients more commonly report maximal ability to participate than RSA patients.

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“…Restoration of shoulder strength has shown to be a determinant of functional outcomes, shoulder range of motion (ROM) and satisfaction following TSA. 13,14 This is considered essential for optimising patient outcomes and best achieved via graduated and progressive physical therapy, consisting of range of motion and strengthening-based exercises. 15…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of formal physical therapy following total shoulder arthroplasty: A systematic review

et al. 2018

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Background Physical therapy is considered routine practice following total shoulder arthroplasty. To date, current regimens are based on clinical opinion, with evidence-based recommendations. The aim of this systematic review was to evaluate the effectiveness of total shoulder arthroplasty physical therapy programmes with a view to inform current clinical practice, as well as to develop a platform upon which future research might be conducted. Methods An electronic search of MEDLINE, EMBASE, CINAHL and Cochrane Library to March 2018 was complemented by hand and citation-searching. Studies were selected in relation to pre-defined criteria. A narrative synthesis was undertaken. Results A total of 506 papers were identified in the electronic database search, with only one study showing moderate evidence of early physical therapy promoting a more rapid return of short-term improvement in function and pain. No studies evaluated the effectiveness of physical therapy programmes in reverse total shoulder arthroplasty procedures. Discussion Restoring range of motion and strength following total shoulder arthroplasty is considered important for patients to obtain a good outcome post-surgery and, when applied early, may offer more rapid recovery. Given the rising incidence of total shoulder arthroplasties, especially reverse total shoulder arthroplasty, there is an urgent need for high-quality, adequately powered randomised controlled trials to determine the effectiveness of rehabilitation programmes following these surgeries.

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Isokinetic strength differences between patients with primary reverse and total shoulder prostheses

Cited by 21 publications

References 35 publications

Clinical measurements versus patient-reported outcomes: analysis of the American Shoulder and Elbow Surgeons physician assessment in patients undergoing reverse total shoulder arthroplasty

Clinical measurements versus patient-reported outcomes: analysis of the American Shoulder and Elbow Surgeons physician assessment in patients undergoing reverse total shoulder arthroplasty

Participation in Work and Sport Following Reverse and Total Shoulder Arthroplasty

Effectiveness of formal physical therapy following total shoulder arthroplasty: A systematic review

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