Higher preoperative expectations predict better outcomes in shoulder surgery patients

Area of Science:

• Orthopedic surgery
• Patient-reported outcomes
• Surgical outcomes research

Background:

• Assessing patient expectations is crucial in orthopedic surgery.
• Preoperative expectations (PE) may influence patient satisfaction and outcomes.
• Understanding the predictive value of PE in shoulder surgery is needed.

Purpose of the Study:

• To determine if preoperative expectations (PE) independently predict 2-year outcomes and improvement in shoulder surgery patients.
• To investigate the association between PE and various patient-reported outcome measures.

Main Methods:

• A cohort of 216 patients undergoing shoulder surgery was studied.
• Patients completed preoperative and 2-year follow-up questionnaires, including PROMIS, ASES, NPS, MARS, and SSQ-8.
• Preoperative expectations were measured using the MODEMS expectations domain.

Main Results:

• Higher preoperative expectations were significantly associated with better 2-year outcomes across multiple measures (ASES, NPS, MARS, SSQ8, PROMIS domains).
• Multivariable analyses confirmed PE as an independent predictor of improved 2-year scores for PROMIS SS, ASES, and shoulder NPS.
• Greater PE predicted better shoulder function, pain relief, and social satisfaction.

Conclusions:

• Preoperative expectations are positively linked to numerous patient-based outcomes two years after shoulder surgery.
• Optimizing realistic patient expectations through counseling may lead to superior surgical outcomes.
• Preoperative assessment of PE is important for managing patient outcomes in shoulder surgery.