Predictors for satisfaction after anatomic total shoulder arthroplasty for idiopathic glenohumeral osteoarthritis

Authors:

Maximilian Petri, Simon A. Euler, Grant J. Dornan, Joshua A. Greenspoon, Marilee P. Horan, J. Christoph Katthagen, Peter J. Millett

Abstract:

The use of total shoulder arthroplasty (TSA) to treat symptomatic glenohumeral osteoarthritis (GHOA) is increasing. In 2008, approximately 27,000 TSAs were performed in the United States, 77 % of which were done to manage GHOA. Several studies have revealed better results and a lower revision rate for TSA compared to hemiarthroplasty for treatment of primary GHOA. The most common causes for failure or complications following TSA are prosthetic loosening, glenohumeral instability, periprosthetic fracture, rotator cuff tears, infection, neural injury, and deltoid muscle dysfunction. Overall reported complication rates after TSA vary between 3 and 22.6 %. Secondary surgery rates have been reported ranging from 6.5 to 11.2 %. Even though long-term revision-free survival rates of primary TSA are reportedly high, 95 % at 10 years and 83.2 % at 20 years, the identification of preoperative factors affecting outcomes is lacking in the literature.

Chen reported a significant correlation between patients’ age and satisfaction after TSA as well as a significant correlation between satisfaction and the ASES score. In addition to female gender, the abnormal glenoid morphology as defined by the Walch classification has been associated with inferior TSA outcomes. It has been reported that patients with glenoid type B according to the Walch classification involving posterior subluxation of the humeral head are at increased risk for complications and failure due to recurrent instability and early glenoid loosening. Johnson et al. recently found that the overall patient’s preoperative health as measured by the American Society of Anesthesiologists (ASA, scale 1–6) score greater than 2 significantly increased the risk for surgical complications in TSAs, reverse TSAs, and revision arthroplasties, with a three times increased risk for prosthesis failure. Harreld et al. demonstrated that patient satisfaction after TSA correlated more with subjective than objective measures such as the ASES score, Simple Shoulder Test, and SF-36 summary scores. They concluded that subjective measures had a relatively low correlation with objective measures.

The purpose of this study was to analyze predictors for satisfaction after anatomic TSA for primary idiopathic GHOA. According to previously published variables, the hypothesis was that men, older age, no prior surgeries, ASA score of 1 or 2 (compared to 3 or more), and Walch glenoids A1 and A2 with centered humeral head (compared to B1 and B2 glenoids with posterior subluxation of the humeral head) would be predictors of patient satisfaction after TSA.

For the complete study: Predictors for satisfaction after anatomic total shoulder arthroplasty for idiopathic glenohumeral osteoarthritis

Peter Millett, MD

Average rating:

39 reviews

Alexandra Thompson

Mar 23, 2024

by Alexandra Thompson on Peter Millett, MD

110%

Dr. Millett and his team did a SLAP tear repair and bicep tenodesis on my left shoulder. I use my arms as an artist, and love to swim in the ocean, surf, paddle, and telemark ski. So regaining full use of my shoulder and keeping my bicep attached was very important to me. Now, over two years later, my shoulder has the equivalent range of motion as my other arm and as before the injury, and no pain. After the first three months it felt so good and was so strong that - to my horror - I completely forgot my six-month follow-up.

Not only did Dr. Millett and his team make my arm as good as new, but having had the experience of such kindness and expertise throughout the process of surgery and recovery is like an added shoulder superpower.

Thank you Rita, Brooke, Jason, Sarah, Camille, Olivia, Dr. Millett and everyone! And see you soon when my husband comes in for his knee...

Jeff Chandler

Jan 31, 2022

by Jeff Chandler on Peter Millett, MD

Flawless procedure, Easy recovery

Dr. Millet's repaired my knee and tibia, following a botched operation by a different surgeon. That procedure was virtually pain free and I was weight bearing within a few days. That was 18 years ago and the knee is still strong. A few years after the knee incident, Dr Millet repaired my shoulder. My insurance company approved me for 3 months of disability following that surgery. I was off pain medication in 2 days and had 90% range of motion within a week. I withdrew my disability claim and returned to work within two weeks of surgery. I’m not a famous athlete—just a regular guy. Nonetheless, I was treated like an NFL at the Steadman clinic. Most notable was the time for recovery. Other surgeons perform their hour-long task in the OR and don’t involve themselves in the other functions. Peter and his team manages the entire process from diagnosis, anesthesia, nursing care, and therapy. He takes a holistic approach to patient care and doesn’t skip any steps.

Jenn West

Jul 2, 2021

by Jenn West on Peter Millett, MD

Saved My Life

I went to Dr. Millett after 7 knee surgeries (6 on my right and 1 on my left) and had seen 11 different surgeons who all refused to remove femur metal from my right leg. I am highly allergic to metal and the chronic pain was leaving me bedridden for 3.5wks out of a month. He personally wrote me back on my inquiry, listened to my concerns, scheduled my surgery within a week (due to insurance issues) and personally followed up with my recovery. The level of patient care from Dr. Millett and his ENTIRE team is above any care I have ever received in my 20 years of dealing with orthopedic surgeons. There are not enough words to describe the level of care, dedication and professionalism you receive from Dr. Millett and his staff.
My only disappointment is that I did not find him sooner!!!

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Predictors for satisfaction after anatomic total shoulder arthroplasty for idiopathic glenohumeral osteoarthritis

Authors:

Abstract:

About the Author: Peter Millett, MD