Preoperative parameters that predict postoperative patient-reported outcome measures and range of motion with anatomic and reverse total shoulder arthroplasty

Abstract

Background: Preoperative factors that most influence postoperative outcomes of both anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) are unknown. The purpose of this study was to identify the preoperative parameters that significantly influence postoperative outcomes of aTSA and rTSA. Methods: The outcomes of 1089 aTSA patients and 1332 rTSA patients (mean follow-up period, 49 months) from an international registry with a single platform system were analyzed. A multiple linear regression model with backward stepwise selection identified the preoperative parameters that were significant predictors of postoperative clinical outcome metric scores and motion measures for both rTSA and aTSA. Results: For both aTSA and rTSA patients, numerous preoperative parameters that influence postoperative outcomes were identified. Greater postoperative range of motion (ROM) was significantly influenced by greater preoperative ROM. For aTSA, greater postoperative American Shoulder and Elbow Surgeons (ASES) scores were significantly influenced by greater preoperative ASES scores, no history of shoulder surgery, and the presence of greater preoperative active external rotation. For rTSA, greater postoperative ASES scores were significantly influenced by greater preoperative ASES scores, no history of shoulder surgery, no history of tobacco use, less preoperative passive external rotation, and greater preoperative active external rotation. Conclusions: This study quantified the preoperative predictors of postoperative clinical outcome metric scores and ROM for both aTSA and rTSA. Numerous significant associations were identified, including demographic and comorbidity risk factors. These associations may be helpful for surgeons to consider when counseling patients regarding aTSA versus rTSA and to establish more accurate expectations prior to surgery.

Three-dimensional kinematics of reverse shoulder arthroplasty: a comparison between shoulders with good or poor elevation

“…The causes of poor functional improvement after RSA are still unclear. Regarding patient factors, age, 15 , 18 female, 15 small and large stature, 27 and high BMI 39 are reported risks for poor outcomes. High BMI was only detected as a factor associated with poor elevation in this study.…”

“… 7 Most patients improve their function including shoulder elevation after surgery, but some patients show less improvement than expected. 18 Various factors have been reported that are related to the poor improvement of shoulder function after RSA including age, 15 , 18 sex, 15 patients’ stature, 27 obesity, 39 deltoid muscle volume, 43 preoperative range of motion, 14 preoperative diagnosis, 11 , 19 , 42 and glenosphere size and position. 6 , 10 , 30 , 32 , 33 …”

Patients Age is a critical Factor in determining the Severity of Osteoarthritis of the Shoulder

“…The success of TSA as a treatment option in patients with shoulder OA is depending on many factors. [21] Objective parameters such as the improvement of range of motion and an increase of strength as well as subjective values like pain reduction are involved in patient satisfaction after surgery. [22,23] The observation that the radiographic OA signs increase with increasing patient age is in line with a previous study.…”

Patients Age is a Critical Factor in Determining the Severity of Osteoarthritis of the Shoulder

“…The success of TSA as a treatment option in patients with shoulder OA is depending on many factors. 11 Objective parameters such as the improvement of range of motion and an increase of strength as well as subjective values like pain reduction are involved in patient satisfaction after surgery. 15,27 The observation that the radiographic OA signs increase with increasing patient age is in line with a previous study.…”