The effect of patient gender on outcomes after reverse total shoulder arthroplasty

• Published in: Journal of shoulder and elbow surgery 2017-11, Vol.26 (11), p.1889-1896
• Main Authors: Wong, Stephanie E., Pitcher, Austin A., Ding, David Y., Cashman, Nicola, Zhang, Alan L., Ma, C. Benjamin, Feeley, Brian T.
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Shoulder - methods; ASES score; Disability Evaluation; Female; gender; Humans; Male; Middle Aged; Osteoarthritis - complications; Osteoarthritis - physiopathology; Osteoarthritis - surgery; Pain Measurement; Patient Reported Outcome Measures; patient-reported outcomes; Postoperative Period; Preoperative Period; Range of Motion, Articular; Reverse total shoulder arthroplasty; Rotator Cuff Tear Arthropathy - complications; Rotator Cuff Tear Arthropathy - physiopathology; Rotator Cuff Tear Arthropathy - surgery; Sex Factors; SF-12 score; shoulder arthroplasty outcomes; Shoulder Pain - etiology; Treatment Outcome
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2017.07.013

Gender differences may exist for patients undergoing shoulder arthroplasty. Limited data suggest that women may have worse preoperative disability and outcomes. Our objective was to determine whether gender influences preoperative disability and patient-reported outcomes after reverse total shoulder arthroplasty. Data were prospectively collected for patients who underwent reverse total shoulder arthroplasty for rotator cuff arthropathy or osteoarthritis with a rotator cuff tear at a single institution between 2009 and 2015. Range of motion, visual analog scale, 12-Item Short Form Health Survey (SF-12), and American Shoulder and Elbow Surgeons (ASES) scores were collected at the preoperative, 1-year, and 2-year postoperative time points. Data were analyzed using multivariate mixed-effect regression analysis. There were 117 patients included. Men and women had similar demographics, preoperative range of motion, pain, and function. Length of stay was similar (men, 2.32 days; women, 2.58 days; P = .18). Controlling for patient variables, men achieved higher ASES function (P = .009) and SF-12 Physical Component Summary (P = .008) scores compared with women. There was no difference between men and women in ASES pain and SF-12 Mental Component Summary scores, visual analog scale score, or range of motion. Improvements in pain and range of motion were similar in men and women; however, men achieved higher ASES function and SF-12 Physical Component Summary scores. Women may be more functionally impaired on the basis of differences in activities of daily living. These results may be used to guide discussion about expected benefits after reverse shoulder arthroplasty.