Psychological disorders confer poor functional outcomes after reverse total shoulder arthroplasty

Reverse total shoulder arthroplasty (RTSA) is being used to treat a number of shoulder disorders. The purpose of the present study was to investigate the correlation between psychological disorders, drug and alcohol abuse, and postoperative complications and outcomes after RTSA.

A total of 128 patients who underwent an RTSA between January 2010 and February 2017 were identified. American Shoulder and Elbow Surgeons, SST, ROM, complications, radiographic outcomes and patient satisfaction were collected. Follow-up occurred at a minimum of 2 years postoperatively (average of 3.68 years). Statistical analysis evaluated the effects of multiple risk factors: psychological disorders, substance abuse, and preoperative diagnoses.

Psychological disorder diagnosis correlated with statistically significant lower American Shoulder and Elbow Surgeons function (P = .027) and Simple Shoulder Test (P = .029) scores compared with those without a psychological disorder. It also conferred poor functional outcomes based on external rotation (P = .012). Complications, especially major complications, were more prevalent in patients with psychological diagnoses than without. A history of substance abuse correlated with a lower external rotation (P = .025).

Both a preoperative psychological diagnosis and a history of substance abuse conferred worse objective and functional outcomes scores after RTSA.