Patientsʼ Preoperative Expectations Predict the Outcome of Rotator Cuff Repair

Henn, R. Frank; Kang, Lana; Tashjian, Robert Z.; Green, Andrew

doi:10.2106/jbjs.f.00358

Cited by 145 publications

(165 citation statements)

References 28 publications

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“…4 The DASH has been used to examine change in disability postoperatively following rotator cuff surgery 3 and also to compare preoperative to postoperative differences in disability. 22,34 For patients following rotator cuff repair, Boissonnault et al 3 reported slightly lower (less disability) average initial DASH score (mean  SD, 52.0  18.3) and lower final DASH score (18.2  12.8) compared to findings in this study. We observed an average initial DASH in the RCR and RCR-SAD groups of essentially 60.0 points and a final DASH score of 25.0 and 20.8 points, respectively.…”

Section: Patient Outcomes Related To Disabilitymentioning

(Expert classified)

Description of Clinical Outcomes and Postoperative Utilization of Physical Therapy Services Within 4 Categories of Shoulder Surgery

Brennan

Parent²,

Cleland³

2010

J Orthop Sports Phys Ther

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provides homogenous categories of patients whose characteristics can be reported.The preponderance of literature that describes outcomes of surgical management for shoulder disorders relates to rotator cuff repair, 12,18 subacromial decomt he incidence of shoulder pain has been estimated at 11.2 per 1000 persons per year and ranks as the third most frequent musculoskeletal complaint of patients visiting a primary care provider. 35 The prevalence of shoulder pain in the general population ranges between 6.9% and 34%. 15The etiology and pathology of shoulder pain can be unclear, which often results in a lack of consensus regarding the appropriate classification of shoulder disorders. 15,35 However, once a patient undergoes a surgical procedure for shoulder pain, the categorization of the patient's shoulder problem is typically described on the basis of the surgical procedure itself. Grouping patients postoperatively on the basis of surgical intervention t studY dEsiGn: Retrospective cohort study. t MEthods: This study included 856 patients (43.7% female; mean  SD age, 51.8  14.2 years) who received outpatient physical therapy following shoulder surgery. Standardized methods for classification of patients to type of shoulder surgery and collection of outcome variables were used. Data were gathered from 57 therapists working in 12 clinics. Patients included had been classified into 1 of 4 surgical categories: repair of a unidirectional instability, rotator cuff repair, rotator cuff repair with a subacromial decompression, or subacromial decompression alone. Descriptive statistics were calculated for baseline characteristics of patients in each surgical category. For all patients, scores on the Disability of the Arm Shoulder and Hand (DASH) questionnaire and a numeric pain rating scale (NPRS) were obtained at the initial and final physical therapy visits, and the change between visits was calculated. Data on number of physical therapy sessions and length of stay (LOS) were collected. For each surgical category, independent-samples t tests were used to determine differences between genders for each initial and final clinical outcome of pain and disability, change scores, utilization of visits, and LOS. The percentage of patients who achieved a minimal clinically important difference (MCID) on the DASH was also determined for each surgical group. For each gender in each surgical category, paired t tests were used to determine if patients achieved significant change in pain and disability.t rEsults: Means for each clinical outcome for the initial and final pain and disability scores, change scores, and the percentage of patients that achieved an MCID are provided. Significant differences were observed between genders for clinical outcomes. In the group treated with unilateral instability repair, women reported significantly greater initial disability than men, and their DASH change scores were significantly greater. In the group that had rotator cuff repairs, women reported significantly greater disability initially a...

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Section: Patient Outcomes Related To Disabilitymentioning

(Expert classified)

Description of Clinical Outcomes and Postoperative Utilization of Physical Therapy Services Within 4 Categories of Shoulder Surgery

Brennan

Parent²,

Cleland³

2010

J Orthop Sports Phys Ther

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“…Although many pain scores have been used for shoulder and elbow surgery, each with varying significance and population sample sizes, the MPQ seemed to be comprehensive as well as concise in order to provide significant data results. 14,25,27,37,49,52 As a pain measure, the VAS was not as strong in this study, probably due to an error when conducted over the phone. The telephone assessment may have also introduced an overall error amongst all of the various scales for the 6wpp period for the 35 of 78 patients who were surveyed over the phone.…”

Section: Discussionmentioning

confidence: 61%

“…4,8,9,16,66 To better control pain, predictive factors need to be used, among which are weight, surgical site, 12 sex, depression, 15 smoking, alcohol, 18 preoperative catastrophizing tendency, anxiety, 22,54,62 preoperative expectations, 25 preoperative pressure pain, 28 loss of passive range of motion, radiographic evidence, glenoid bone erosion, 30 preoperative pain, age, type of surgery, 31 prediction rules, 33 Spielberger's State Trait Anxiety Inventory, health-related quality of life (Medical Outomes Study Short-Form 35-item Health Survey), 35 chronic sleeping difficulties, 44 fear, 61 and the MPQ. 63 Many of these predictive factors have been significant in determining postoperative pain intensity; however, to focus on anticipated and preoperative pain as predictive factors we used the SF-MPQ.…”

mentioning

confidence: 99%

Postoperative pain associated with orthopedic shoulder and elbow surgery: a prospective study

Desai¹,

Cheung²

2012

Journal of Shoulder and Elbow Surgery

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“…Patient's expectations have been shown to affect the subjective outcome [28,58,70]. Once again, the predictive role of fatty infiltration and muscle atrophy could not be clearly stated due to inadequate number of studies and conflicting results.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors influencing the outcome of rotator cuff repair: a systematic review

Saccomanno

Sircana

Cazzato

et al. 2015

Knee Surg Sports Traumatol Arthrosc

123

101

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Patientsʼ Preoperative Expectations Predict the Outcome of Rotator Cuff Repair

Abstract: Patients' preoperative expectations regarding rotator cuff repair are associated with their actual self-assessed outcome. Variations in patient expectations may help to explain divergent results in published series as well as among various patient populations.

Cited by 145 publications

References 28 publications

Description of Clinical Outcomes and Postoperative Utilization of Physical Therapy Services Within 4 Categories of Shoulder Surgery

Description of Clinical Outcomes and Postoperative Utilization of Physical Therapy Services Within 4 Categories of Shoulder Surgery

Postoperative pain associated with orthopedic shoulder and elbow surgery: a prospective study

Prognostic factors influencing the outcome of rotator cuff repair: a systematic review

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