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Differences in Patients' and Surgeons' Expectations before Shoulder Stabilization Surgery.

Katrin Karpinski1, Fabian Plachel1, Christian Gerhardt2

  • 1Centrum für Muskuloskeletale Chirurgie, Klinik für Schulter- und Ellenbogenchirurgie, Charité Universitätsmedizin Berlin, 13353 Berlin, Germany.

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|October 23, 2021
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Summary
This summary is machine-generated.

Patients and surgeons have similar expectations for shoulder stabilization surgery, though surgeons may overemphasize stability. Understanding patient goals beyond just preventing dislocation is crucial for successful outcomes in shoulder instability treatment.

Keywords:
patients’ expectationsshoulder instabilityshoulder stabilizationsurgeons’ expectations

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Patient-Reported Outcomes

Background:

  • Shoulder stabilization surgery aims to restore joint stability, often measured solely by preventing re-dislocation.
  • Patients have broader expectations, including pain relief, improved range of motion, strength, and psychological well-being.
  • Discrepancies between surgeon and patient expectations can impact perceived surgical success.

Purpose of the Study:

  • To determine if surgeons accurately understand patient expectations following shoulder stabilization surgery.
  • To investigate the influence of various factors on patient expectations for shoulder stabilization outcomes.

Main Methods:

  • Prospective, multicenter study involving 204 patients undergoing shoulder stabilization surgery.
  • Preoperative assessment of objective and subjective scores, alongside patient interviews regarding expectations.
  • Interviews with 25 surgeons using standardized questions to gauge their perception of patient expectations.

Main Results:

  • Patients prioritized shoulder stability, followed by improved ability to exercise/participate in sports, and return to pre-injury state.
  • Surgeons ranked stability highest, but showed significant differences from patients regarding the trade-off between stability and movement (p=0.001).
  • Surgeons tended to overrate the importance of stability compared to other factors like movement and pain.

Conclusions:

  • Patient and surgeon expectations for shoulder stabilization surgery are largely aligned, with minor disagreements.
  • Surgeons may overestimate the importance of achieving stability at the expense of other crucial patient-centered outcomes.
  • Aligning surgeon and patient expectations is key to improving satisfaction and perceived success in shoulder stabilization procedures.