Anatomic Total Shoulder : Predictors of Excellent Outcomes at Five Years after Arthroplasty

© 2024. The Author(s) under exclusive licence to SICOT aisbl..

PURPOSE: The objectives of this study were to: report minimum 5-year outcomes in patients undergoing TSA and determine characteristics predictive of patients achieving an excellent functional outcome.

METHODS: Pre-operative demographic variables and Simple Shoulder Test (SST) scores were obtained pre-operatively and at a minimum of five years after surgery. A final SST ≥ 10 and percentage of maximal possible improvement (% MPI) of ≥ 66.7% were determined to be the thresholds for excellent outcomes. Univariate and multivariate analysis were performed to identify factors associated with excellent five year clinical outcomes.

RESULTS: Of 233 eligible patients, 188 (81%) had adequate follow-up for inclusion in this study. Mean SST scores improved from 3.4 ± 2.4 to 9.7 ± 2.2 (p < 0.001). Male sex was an independent predictor of both SST ≥ 10 (OR 3.46, 95% CI 1.70-7.31; p < 0.001) and %MPI ≥ 66.7 (OR 2.27, 95% CI 1.11-4.81, p = 0.027). Workers' Compensation insurance was predictive of not obtaining SST ≥ 10 (OR 0.12, 95% 0.02-0.60; p = 0.016) or %MPI ≥ 66.7 (OR 0.16, 95% CI 0.03-0.77, p = 0.025). MCID was passed by the vast majority (95%) of patients undergoing TSA and did not necessarily indicate an excellent, satisfactory outcome.

CONCLUSION: Male sex and commercial insurance coverage were significantly associated with these excellent outcomes, while Workers' Compensation insurance was associated with failure to achieve this result. Thresholds for excellent outcomes, such as final SST ≥ 10 and %MPI ≥ 66.7, may be useful in identifying the characteristics of patients who benefit most from TSA.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:48

Enthalten in:

International orthopaedics - 48(2024), 5 vom: 24. Apr., Seite 1277-1283

Sprache:

Englisch

Beteiligte Personen:

Mills, Zachary D [VerfasserIn]
Schiffman, Corey J [VerfasserIn]
Sharareh, Behnam [VerfasserIn]
Whitson, Anastasia J [VerfasserIn]
Matsen, Frederick A [VerfasserIn]
Hsu, Jason E [VerfasserIn]

Links:

Volltext

Themen:

Excellent outcomes
Glenohumeral arthritis
Journal Article
Mid-term follow-up
Total shoulder arthroplasty

Anmerkungen:

Date Completed 10.04.2024

Date Revised 23.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s00264-024-06148-x

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM36989359X