Comparison of satisfied and dissatisfied patients 2 to 5 years after anatomic total shoulder arthroplasty

J Shoulder Elbow Surg. 2016 Jul;25(7):1128-32. doi: 10.1016/j.jse.2015.12.001. Epub 2016 Feb 17.


Background: With an increasingly large number of patients undergoing total shoulder arthroplasty (TSA) combined with increased requirements for public reporting of patient outcomes, there is a greater need to better understand the underlying factors related to patient satisfaction. The purpose of this study was to compare patient demographics, nonorthopedic comorbidities, patient-reported outcome scores, and range of motion of patients who reported being either satisfied or dissatisfied with their procedure at midterm follow-up.

Methods: We identified 234 primary TSAs performed by a single surgeon for glenohumeral osteoarthritis with a minimum 2-year follow-up in a prospective shoulder arthroplasty registry. American Shoulder and Elbow Surgeons (ASES) score, patient satisfaction, and active forward flexion, abduction, and external rotation at 0° of flexion-abduction were assessed before and after TSA.

Results: Of the 234 patients, 207 (88.5%) were satisfied with their procedure. Dissatisfied patients had significantly lower ASES scores both before and after surgery (P < .001) as well as a significantly lower preoperative to postoperative change in ASES score (P < .001). Similarly, dissatisfied patients demonstrated significantly lower changes in active forward flexion (P = .004), abduction (P = .02), and external rotation (P = .03). Patients with ASES score changes <12 points were 19 times more likely to be dissatisfied after TSA (95% confidence interval, 4.4-81.4; P = .0001).

Conclusion: Dissatisfied patients had significantly lower improvements in pain, function, and range of motion. Furthermore, a change in ASES score <12 points was associated with a 19-fold increase in the risk of being dissatisfied after TSA.

Keywords: Total shoulder arthroplasty; activities of daily living; osteoarthritis; outcome; pain; range of motion; satisfaction.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Shoulder*
  • Comorbidity
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis / complications
  • Osteoarthritis / physiopathology
  • Osteoarthritis / surgery
  • Patient Satisfaction*
  • Postoperative Period
  • Preoperative Period
  • Range of Motion, Articular*
  • Retrospective Studies
  • Rotation
  • Severity of Illness Index*
  • Shoulder Joint / physiopathology*
  • Shoulder Pain / etiology
  • Treatment Outcome