Arthroscopy: The Journal of Arthroscopic & Related Surgery
Level V EvidencePatient Understanding, Expectations, and Satisfaction Regarding Rotator Cuff Injuries and Surgical Management
Section snippets
Introduction: Association Between Patient Understanding, Expectations, and Satisfaction
Patient satisfaction and patient-reported outcomes (PROs) are becoming increasingly important outcome metrics as orthopaedics and health care in general strive for a more patient-centered model. Pain and functional limitation are frequently driving factors for patients seeking intervention, and patients have variable expectations of the level of improvement that they will experience after surgery.1 Although many variables influence patient satisfaction with orthopaedic surgery, a key
Patient Education: Rotator Cuff Injuries and Surgical Management
Rotator cuff injuries affect about 17 million people in the United States and are among the most common presentations for orthopaedic care.7, 8 Rotator cuff repair surgery is one of the most common orthopaedic procedures with an estimated 200,000 to 300,000 repairs each year.9 Although a paucity of information exists regarding patient understanding/perception of rotator cuff injuries and management options, many have reported on the quality of patient education materials with regard to rotator
Patient Expectations and Concerns for Rotator Cuff Surgery
Many investigators have sought to elucidate patient-specific and injury-specific factors that influence expectations and concerns for surgical management of rotator cuff tears. In a prospective study of 125 patients who underwent primary repair for chronic rotator cuff tears, Henn et al.17 evaluated preoperative patient expectations. They used 6 questions from the Musculoskeletal Outcomes Data Evaluation and Management System (MODEMS) questionnaire, and obtained PROs both preoperatively and
Factors Influencing Patient Satisfaction With Rotator Cuff Surgery
As Makhni et al.21 showed in their recent systematic review of outcome assessment measures for rotator cuff pathology, obtaining patient satisfaction scores has not yet become routine for many orthopaedic practices. However, there is little doubt regarding the significance of patient satisfaction scores going forward. O'Holleran and colleagues22 evaluated determinants of patient satisfaction after rotator cuff surgery. In their cohort of 57 patients with minimum 1-year follow-up, the authors
Discussion
Although this evidence is important for treating providers to be aware of when counseling patients, the approach to counseling should be patient specific. It is essential to understand and address patients' individual concerns and goals for treatment. Patients often present to orthopaedic surgeons with limited knowledge regarding their injury and management options. Information is often obtained from the internet, frequently through sources with low-quality, difficult-to-understand content
Conclusions
Many factors affect patient satisfaction after rotator cuff surgery. Large rotator cuff tears, subscapularis tears, persistence of postoperative pain and dysfunction, worker's compensation cases, lower education level, and preoperative disability are more frequently seen in patients reporting poor satisfaction. Comparatively, being married, employed, and of older age at the time of surgery (>55 years old) predicts higher satisfaction. Patient education preoperatively regarding details about the
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Female Sex and Higher Infraspinatus Fatty Infiltration Are Linked to Dissatisfaction at a Minimum Follow-Up of 4 Years after Arthroscopic Repair of Massive Rotator Cuff Tears
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2022, Arthroscopy - Journal of Arthroscopic and Related SurgeryCitation Excerpt :Patients’ expectations, and the fulfillment of such expectations, have been demonstrated to be strong predictors of surgical outcomes and satisfaction.1,2,3,4
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2022, Arthroscopy - Journal of Arthroscopic and Related SurgeryCitation Excerpt :Patients without workers compensation may experience greater subjective improvement and may be more motivated to return to work. Nonetheless, preoperative patient expectations have been shown to impact clinical outcomes.59,60 The results of this study can help to support the counseling of the patient undergoing shoulder stabilization in terms of expectations and satisfaction.
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2021, Arthroscopy, Sports Medicine, and RehabilitationCitation Excerpt :Our findings suggest that although arthroscopic suprapectoral onlay single-anchor biceps tenodesis in conjunction with other common shoulder procedures may help provide overall reliable results for patients looking to return to occupational duties, the postoperative return among individuals with more intense physical demands may be prolonged and less predictable. It would be beneficial for surgeons to take this into account when counseling heavy-duty laborers preoperatively because fulfillment of preoperative expectations has been significantly linked with postoperative patient satisfaction.30-34 In recent systematic reviews by Abraham et al.35 and Hurley et al.,36 the authors showed that arthroscopic biceps tenodesis could lead to significant improvements in validated outcome scores (ASES, Simple Shoulder Test, VAS, and Disabilities of the Arm, Shoulder and Hand scores) and clinical ROM postoperatively, with results comparable to those of open techniques.
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The authors report the following potential conflicts of interest or sources of funding: B.J.C. receives support from Aesculap/B. Braun, American Journal of Orthopedics, American Orthopaedic Society for Sports Medicine, American Shoulder and Elbow Surgeons, Arthrex, Arthroscopy, Arthroscopy Association of North America, Athletico, Carticept, DJ Orthopaedics, Elsevier Publishing, International Cartilage Repair Society, Journal of Bone & Joint Surgery—American, Journal of Shoulder and Elbow Surgery, Journal of the American Academy of Orthopaedic Surgeons, Medipost, National Institutes of Health (NIAMS & NICHD), Ossur, Regentis, Saunders/Mosby-Elsevier, Smith & Nephew, and Tornier.