Patient understanding, expectations, outcomes, and satisfaction regarding surgical management of shoulder instability

Shoulder instability is a common condition encountered by sports medicine and shoulder surgeons. Management can be challenging, both with regards to the underlying pathology and the high expectations associated with the very active patient population that this condition typically affects. High-performance athletes who are used to performing at activity levels which typically challenge the normal physiologic limits of the glenohumeral joint may be particularly difficult to treat. As physicians increasingly evaluate patient reported outcomes (PROs), a growing body of literature has emerged related to patient expectations for a variety of orthopaedic conditions, including shoulder instability. Physicians may face difficulty when using the literature to counsel patients due to the difference between a successful PRO and true patient satisfaction. Having a better understanding of patient expectations may improve preoperative evaluation, patient counseling, postoperative PROs, and patient satisfaction with shoulder instability surgery. The purpose of this paper was to review the literature regarding patient understanding of shoulder instability injuries, expectations following surgical repair of shoulder instability pathology, and satisfaction with operative intervention. Additionally, we sought to determine the effect of patient expectations on outcomes.