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Risk factors for failing to achieve improvement after anatomic total shoulder arthroplasty for glenohumeral osteoarthritis
Although anatomic total shoulder arthroplasty (TSA) successfully improves pain and function, not all patients improve clinically. This study was conducted to determine patient-related factors for failure to achieve improvement after primary TSA for osteoarthritis at 2 years postoperatively. This pro...
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Published in: | Journal of shoulder and elbow surgery 2018-06, Vol.27 (6), p.968-975 |
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container_title | Journal of shoulder and elbow surgery |
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creator | Mahony, Gregory T. Werner, Brian C. Chang, Brenda Grawe, Brian M. Taylor, Samuel A. Craig, Edward V. Warren, Russell F. Dines, David M. Gulotta, Lawrence V. |
description | Although anatomic total shoulder arthroplasty (TSA) successfully improves pain and function, not all patients improve clinically. This study was conducted to determine patient-related factors for failure to achieve improvement after primary TSA for osteoarthritis at 2 years postoperatively.
This prospective study reviewed an institutional shoulder registry for consecutive patients who underwent primary TSA for osteoarthritis from 2007 to 2013 with baseline and 2-year postoperative American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form scores. A failed outcome was defined as (1) a failure to reach the ASES minimal clinically important difference of 16.1 points or (2) revision surgery within 2 years of the index procedure, or both. Univariate and multivariable analyses of clinical and demographic patient factors were performed using logistic regression.
Of 459 arthroplasties that met inclusion criteria, 411 were deemed successful by the aforementioned criteria, and 48 (10.5%) failed to achieve a desirable outcome. Clinical risk factors associated with failure included previous surgery to the shoulder (P = .047), presence of a torn rotator cuff (P = .025), and presence of diabetes (P = .036), after adjusting for age, sex, race, and body mass index. A higher preoperative ASES score at baseline was associated with failure (P |
doi_str_mv | 10.1016/j.jse.2017.12.018 |
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This prospective study reviewed an institutional shoulder registry for consecutive patients who underwent primary TSA for osteoarthritis from 2007 to 2013 with baseline and 2-year postoperative American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form scores. A failed outcome was defined as (1) a failure to reach the ASES minimal clinically important difference of 16.1 points or (2) revision surgery within 2 years of the index procedure, or both. Univariate and multivariable analyses of clinical and demographic patient factors were performed using logistic regression.
Of 459 arthroplasties that met inclusion criteria, 411 were deemed successful by the aforementioned criteria, and 48 (10.5%) failed to achieve a desirable outcome. Clinical risk factors associated with failure included previous surgery to the shoulder (P = .047), presence of a torn rotator cuff (P = .025), and presence of diabetes (P = .036), after adjusting for age, sex, race, and body mass index. A higher preoperative ASES score at baseline was associated with failure (P < .001).
Previous shoulder surgery, a rotator cuff tear requiring repair during TSA, presence of diabetes, surgery on the nondominant arm, and a higher baseline ASES score were associated with a higher risk of failing to achieve improvement after anatomic TSA.</description><identifier>ISSN: 1058-2746</identifier><identifier>EISSN: 1532-6500</identifier><identifier>DOI: 10.1016/j.jse.2017.12.018</identifier><identifier>PMID: 29482959</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Arthroplasty, Replacement, Shoulder ; ASES score ; Diabetes Complications - complications ; Female ; Follow-Up Studies ; glenohumeral arthritis ; Humans ; Male ; MCID ; Middle Aged ; Osteoarthritis - complications ; Osteoarthritis - surgery ; Patient Reported Outcome Measures ; poor improvement ; postoperative outcomes ; Postoperative Period ; Prospective Studies ; Registries ; Reoperation ; Risk Factors ; Rotator Cuff Injuries - complications ; satisfaction ; Severity of Illness Index ; Shoulder Joint - physiopathology ; Shoulder Joint - surgery ; Shoulder Pain - etiology ; Total shoulder arthoplasty ; Treatment Failure</subject><ispartof>Journal of shoulder and elbow surgery, 2018-06, Vol.27 (6), p.968-975</ispartof><rights>2017 Journal of Shoulder and Elbow Surgery Board of Trustees</rights><rights>Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-91004273cd4a001bc12d7b3158423b8fc7394a35a1305caa946d589befd7dbae3</citedby><cites>FETCH-LOGICAL-c353t-91004273cd4a001bc12d7b3158423b8fc7394a35a1305caa946d589befd7dbae3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29482959$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mahony, Gregory T.</creatorcontrib><creatorcontrib>Werner, Brian C.</creatorcontrib><creatorcontrib>Chang, Brenda</creatorcontrib><creatorcontrib>Grawe, Brian M.</creatorcontrib><creatorcontrib>Taylor, Samuel A.</creatorcontrib><creatorcontrib>Craig, Edward V.</creatorcontrib><creatorcontrib>Warren, Russell F.</creatorcontrib><creatorcontrib>Dines, David M.</creatorcontrib><creatorcontrib>Gulotta, Lawrence V.</creatorcontrib><title>Risk factors for failing to achieve improvement after anatomic total shoulder arthroplasty for glenohumeral osteoarthritis</title><title>Journal of shoulder and elbow surgery</title><addtitle>J Shoulder Elbow Surg</addtitle><description>Although anatomic total shoulder arthroplasty (TSA) successfully improves pain and function, not all patients improve clinically. This study was conducted to determine patient-related factors for failure to achieve improvement after primary TSA for osteoarthritis at 2 years postoperatively.
This prospective study reviewed an institutional shoulder registry for consecutive patients who underwent primary TSA for osteoarthritis from 2007 to 2013 with baseline and 2-year postoperative American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form scores. A failed outcome was defined as (1) a failure to reach the ASES minimal clinically important difference of 16.1 points or (2) revision surgery within 2 years of the index procedure, or both. Univariate and multivariable analyses of clinical and demographic patient factors were performed using logistic regression.
Of 459 arthroplasties that met inclusion criteria, 411 were deemed successful by the aforementioned criteria, and 48 (10.5%) failed to achieve a desirable outcome. Clinical risk factors associated with failure included previous surgery to the shoulder (P = .047), presence of a torn rotator cuff (P = .025), and presence of diabetes (P = .036), after adjusting for age, sex, race, and body mass index. A higher preoperative ASES score at baseline was associated with failure (P < .001).
Previous shoulder surgery, a rotator cuff tear requiring repair during TSA, presence of diabetes, surgery on the nondominant arm, and a higher baseline ASES score were associated with a higher risk of failing to achieve improvement after anatomic TSA.</description><subject>Adult</subject><subject>Aged</subject><subject>Arthroplasty, Replacement, Shoulder</subject><subject>ASES score</subject><subject>Diabetes Complications - complications</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>glenohumeral arthritis</subject><subject>Humans</subject><subject>Male</subject><subject>MCID</subject><subject>Middle Aged</subject><subject>Osteoarthritis - complications</subject><subject>Osteoarthritis - surgery</subject><subject>Patient Reported Outcome Measures</subject><subject>poor improvement</subject><subject>postoperative outcomes</subject><subject>Postoperative Period</subject><subject>Prospective Studies</subject><subject>Registries</subject><subject>Reoperation</subject><subject>Risk Factors</subject><subject>Rotator Cuff Injuries - complications</subject><subject>satisfaction</subject><subject>Severity of Illness Index</subject><subject>Shoulder Joint - physiopathology</subject><subject>Shoulder Joint - surgery</subject><subject>Shoulder Pain - etiology</subject><subject>Total shoulder arthoplasty</subject><subject>Treatment Failure</subject><issn>1058-2746</issn><issn>1532-6500</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kE1r3DAQhkVJaD7aH9BL8TEXu6OvtUxPIaRJIFAIyVnI0jirrW1tJXkh_fXVZtMce5pheN4X5iHkC4WGAl192zSbhA0D2jaUNUDVB3JKJWf1SgIclR2kqlkrVifkLKUNAHQC2EdywjqhWCe7U_Lnwadf1WBsDjFVQ4hl96Ofn6scKmPXHndY-Wkbww4nnHNlhoyxMrPJYfK2UNmMVVqHZXT7e8zrGLajSfnlte15xDmslwljwULKGF4Rn336RI4HMyb8_DbPydOP68er2_r-583d1eV9bbnkue4ogGAtt04YANpbylzbcyqVYLxXg215JwyXhnKQ1phOrJxUXY-Da11vkJ-Ti0NveeL3ginrySeL42hmDEvSDEApJQWDgtIDamNIKeKgt9FPJr5oCnqvXG90Ua73yjVluigvma9v9Us_oXtP_HNcgO8HAMuTO49RJ-txtuh8RJu1C_4_9X8BV4iU1Q</recordid><startdate>201806</startdate><enddate>201806</enddate><creator>Mahony, Gregory T.</creator><creator>Werner, Brian C.</creator><creator>Chang, Brenda</creator><creator>Grawe, Brian M.</creator><creator>Taylor, Samuel A.</creator><creator>Craig, Edward V.</creator><creator>Warren, Russell F.</creator><creator>Dines, David M.</creator><creator>Gulotta, Lawrence V.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201806</creationdate><title>Risk factors for failing to achieve improvement after anatomic total shoulder arthroplasty for glenohumeral osteoarthritis</title><author>Mahony, Gregory T. ; Werner, Brian C. ; Chang, Brenda ; Grawe, Brian M. ; Taylor, Samuel A. ; Craig, Edward V. ; Warren, Russell F. ; Dines, David M. ; Gulotta, Lawrence V.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-91004273cd4a001bc12d7b3158423b8fc7394a35a1305caa946d589befd7dbae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Arthroplasty, Replacement, Shoulder</topic><topic>ASES score</topic><topic>Diabetes Complications - complications</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>glenohumeral arthritis</topic><topic>Humans</topic><topic>Male</topic><topic>MCID</topic><topic>Middle Aged</topic><topic>Osteoarthritis - complications</topic><topic>Osteoarthritis - surgery</topic><topic>Patient Reported Outcome Measures</topic><topic>poor improvement</topic><topic>postoperative outcomes</topic><topic>Postoperative Period</topic><topic>Prospective Studies</topic><topic>Registries</topic><topic>Reoperation</topic><topic>Risk Factors</topic><topic>Rotator Cuff Injuries - complications</topic><topic>satisfaction</topic><topic>Severity of Illness Index</topic><topic>Shoulder Joint - physiopathology</topic><topic>Shoulder Joint - surgery</topic><topic>Shoulder Pain - etiology</topic><topic>Total shoulder arthoplasty</topic><topic>Treatment Failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mahony, Gregory T.</creatorcontrib><creatorcontrib>Werner, Brian C.</creatorcontrib><creatorcontrib>Chang, Brenda</creatorcontrib><creatorcontrib>Grawe, Brian M.</creatorcontrib><creatorcontrib>Taylor, Samuel A.</creatorcontrib><creatorcontrib>Craig, Edward V.</creatorcontrib><creatorcontrib>Warren, Russell F.</creatorcontrib><creatorcontrib>Dines, David M.</creatorcontrib><creatorcontrib>Gulotta, Lawrence V.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of shoulder and elbow surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mahony, Gregory T.</au><au>Werner, Brian C.</au><au>Chang, Brenda</au><au>Grawe, Brian M.</au><au>Taylor, Samuel A.</au><au>Craig, Edward V.</au><au>Warren, Russell F.</au><au>Dines, David M.</au><au>Gulotta, Lawrence V.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for failing to achieve improvement after anatomic total shoulder arthroplasty for glenohumeral osteoarthritis</atitle><jtitle>Journal of shoulder and elbow surgery</jtitle><addtitle>J Shoulder Elbow Surg</addtitle><date>2018-06</date><risdate>2018</risdate><volume>27</volume><issue>6</issue><spage>968</spage><epage>975</epage><pages>968-975</pages><issn>1058-2746</issn><eissn>1532-6500</eissn><abstract>Although anatomic total shoulder arthroplasty (TSA) successfully improves pain and function, not all patients improve clinically. This study was conducted to determine patient-related factors for failure to achieve improvement after primary TSA for osteoarthritis at 2 years postoperatively.
This prospective study reviewed an institutional shoulder registry for consecutive patients who underwent primary TSA for osteoarthritis from 2007 to 2013 with baseline and 2-year postoperative American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form scores. A failed outcome was defined as (1) a failure to reach the ASES minimal clinically important difference of 16.1 points or (2) revision surgery within 2 years of the index procedure, or both. Univariate and multivariable analyses of clinical and demographic patient factors were performed using logistic regression.
Of 459 arthroplasties that met inclusion criteria, 411 were deemed successful by the aforementioned criteria, and 48 (10.5%) failed to achieve a desirable outcome. Clinical risk factors associated with failure included previous surgery to the shoulder (P = .047), presence of a torn rotator cuff (P = .025), and presence of diabetes (P = .036), after adjusting for age, sex, race, and body mass index. A higher preoperative ASES score at baseline was associated with failure (P < .001).
Previous shoulder surgery, a rotator cuff tear requiring repair during TSA, presence of diabetes, surgery on the nondominant arm, and a higher baseline ASES score were associated with a higher risk of failing to achieve improvement after anatomic TSA.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29482959</pmid><doi>10.1016/j.jse.2017.12.018</doi><tpages>8</tpages></addata></record> |
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subjects | Adult Aged Arthroplasty, Replacement, Shoulder ASES score Diabetes Complications - complications Female Follow-Up Studies glenohumeral arthritis Humans Male MCID Middle Aged Osteoarthritis - complications Osteoarthritis - surgery Patient Reported Outcome Measures poor improvement postoperative outcomes Postoperative Period Prospective Studies Registries Reoperation Risk Factors Rotator Cuff Injuries - complications satisfaction Severity of Illness Index Shoulder Joint - physiopathology Shoulder Joint - surgery Shoulder Pain - etiology Total shoulder arthoplasty Treatment Failure |
title | Risk factors for failing to achieve improvement after anatomic total shoulder arthroplasty for glenohumeral osteoarthritis |
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