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The "tipping point" for 931 elective shoulder arthroplasties
Jeremy S Somerson1, Jason E Hsu2, Moni B Neradilek3
1Department of Orthopaedic Surgery and Rehabilitation, University of Texas Medical Branch, Galveston, TX, USA.
Journal of Shoulder and Elbow Surgery
|May 12, 2018
Summary
Patients decide on shoulder replacement surgery at their personal "tipping point" of pain and dysfunction. Factors like age, health, and insurance influence this decision for shoulder arthroplasty.
Area of Science:
- Orthopedics
- Patient-Reported Outcomes
- Surgical Decision-Making
Background:
- Arthritis symptoms progress over time, eventually leading patients to consider joint replacement surgery.
- The decision point for surgery, termed the 'tipping point,' is defined by symptom severity impacting comfort and function.
Purpose of the Study:
- To investigate the factors influencing the 'tipping point' for patients undergoing elective shoulder arthroplasty.
- To understand patient-specific determinants for proceeding with shoulder replacement surgery.
Main Methods:
- Analysis of 931 patients who underwent shoulder arthroplasty.
- Characterization of the 'tipping point' based on patient-reported comfort and function using the Simple Shoulder Test (SST) score.
Main Results:
- The average preoperative Simple Shoulder Test (SST) score was 3.6 ± 2.7.
- Tipping points varied by procedure type, with ream-and-run averaging the highest SST score (5.0 ± 2.5) and reverse total shoulder arthroplasty the lowest (1.5 ± 1.8).
- Factors associated with a higher tipping point included younger age, better health, male sex, commercial insurance, marriage, non-narcotic use, alcohol consumption, and non-work-related shoulder issues.
Conclusions:
- The 'tipping point' reflects a patient's self-assessed threshold for comfort and function when deciding on shoulder replacement.
- Understanding these factors aids surgeons in recognizing patient indications for shoulder arthroplasty.