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Related Concept Videos

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Assessing Appropriateness for Shoulder Arthroplasty Using a Shared Decision-Making Process.

Helen Razmjou1,2,3, Monique Christakis4, Diane Nam5,6

  • 1Department of Rehabilitation, Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto, Canada.

Journal of Shoulder and Elbow Arthroplasty
|April 3, 2023
PubMed
Summary
This summary is machine-generated.

A new 5-item tool effectively identifies patients ready for glenohumeral arthritis surgery. Patient factors like gender and expectations, not imaging, influenced surgical decisions.

Keywords:
Osteoarthritiscuff tear arthroplastyengagementshared decision making

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Area of Science:

  • Orthopedics
  • Patient-centered care
  • Surgical decision-making

Background:

  • Glenohumeral arthritis management often involves surgical intervention.
  • Patient engagement in surgical decision-making is crucial for optimal outcomes.
  • Assessing patient readiness for surgery requires validated tools.

Purpose of the Study:

  • To validate an appropriateness decision-aid tool for patients with glenohumeral arthritis.
  • To examine patient characteristics associated with the decision for surgical management.

Main Methods:

  • An observational study involving 80 patients with glenohumeral arthritis.
  • Data collected included demographics, health status, expectations, pain (Visual Analog Scale), and function (American Shoulder & Elbow Surgeon score).
  • A 5-item Likert survey assessed appropriateness for arthroplasty, alongside clinical and imaging evaluations.

Main Results:

  • The decision-aid tool demonstrated excellent validity (AUC=0.93) in distinguishing patients ready for surgery.
  • Factors significantly influencing the surgical decision included gender, overall health, external rotation strength, pain severity, ASES score, and patient expectations.
  • Imaging findings were not significant predictors of the final surgical decision.

Conclusions:

  • A 5-item tool is highly effective in differentiating surgical readiness for glenohumeral arthritis.
  • Patient-reported factors such as gender, expectations, strength, and self-assessed outcomes are key determinants in surgical decision-making.