Determinants of patient satisfaction following surgery for multidirectional instability

Fifty shoulders in 46 patients underwent stabilization surgery for multidirectional instability. Univariate analysis showed no significant differences (P>0.05) for age, gender, or workers' compensation in patient satisfaction or American Shoulder and Elbow Surgeons (ASES) score. Only the ASES score was lower with prior surgery (P=0.001). There was a significantly increased ASES score (P<0.05) for arthroscopic versus open treatment. Subjective variable analysis showed that satisfaction and ASES score were significantly associated with questions regarding pain, instability, and upper extremity use (P<0.01). Increased range of motion showed a trend toward higher ASES scores (P<0.074). Patient satisfaction (P=0.013) was associated with greater forward elevation and greater external rotation (P=0.056). Multivariate analysis (P<0.05) showed that independent determinants of patient satisfaction with outcome included change in instability symptoms and ASES score. Subjective variables of symptoms and motion had the greatest correlation with patient satisfaction and ASES score following surgery for multidirectional shoulder instability. To improve patient satisfaction, an expanded focus on these subjective points may be beneficial.