When do patients truly reach maximal medical improvement after undergoing reverse shoulder arthroplasty? The incidence and clinical significance of pain and patient-reported outcome measure improvement

© 2020 The Author(s).

Bibliographische Detailangaben
Veröffentlicht in:JSES international. - 2020. - 4(2020), 3 vom: 25. Sept., Seite 675-679
1. Verfasser: Matar, Robert N (VerfasserIn)
Weitere Verfasser: Gardner, Tyler J, Kassam, Farzaan, Grawe, Brian M
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2020
Zugriff auf das übergeordnete Werk:JSES international
Schlagworte:Journal Article Shoulder arthroplasty maximum medical improvement pain patient-reported outcome measures reverse total shoulder arthroplasty sports medicine
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245 1 0 |a When do patients truly reach maximal medical improvement after undergoing reverse shoulder arthroplasty? The incidence and clinical significance of pain and patient-reported outcome measure improvement 
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520 |a © 2020 The Author(s). 
520 |a HYPOTHESIS: Patients receiving reverse total shoulder arthroplasty (RTSA) may reach MMI prior to 12 months postoperatively 
520 |a BACKGROUND: With the growth of RTSA indications, there is a paucity of information regarding maximum medical improvement (MMI) after these procedures. Systems of evaluating recovery, such as patient-reported outcome measures and minimal clinically important differences (MCIDs) will allow for measurement of when patients reach maximum medical improvement (MMI) after these procedures 
520 |a PURPOSE: To evaluate when patients have reached MMI after RTSA 
520 |a METHODS: Patients were prospectively enrolled in the institution's RTSA registry. All patients undergoing RTSA who agreed to be enrolled were included. Patient-specific factors, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) score, and pain data were collected preoperatively and at 6 and 12 months postoperatively. Subgroup analysis was performed on preoperative diagnosis before analyzing MCID and MMI. MMI was calculated by using the last time point interval that an MCID did not occur 
520 |a RESULTS: Of 182 patients, 92 had complete 12-month postoperative data, including visual analog scale (VAS) pain and ASES scores. Subgroup analysis showed preoperative diagnosis of rotator cuff arthropathy, revision surgery, glenohumeral arthritis, proximal humerus fracture, and chronic dislocation. All 5 groups had improvement that exceeded MCID thresholds at 6 months and variable improvement from 6-12 months. Analysis of variance compared the different groups, showing that VAS pain scores and ASES scores were different at all time points except for preoperative VAS pain scores 
520 |a CONCLUSIONS: Patients undergoing RTSA may reach MMI at 6 months instead of the previously reported 1-year time point. Data from this study can allow providers to deliver value care and potentially limit visits after 6 months postoperatively 
650 4 |a Journal Article 
650 4 |a Shoulder arthroplasty 
650 4 |a maximum medical improvement 
650 4 |a pain 
650 4 |a patient-reported outcome measures 
650 4 |a reverse total shoulder arthroplasty 
650 4 |a sports medicine 
700 1 |a Gardner, Tyler J  |e verfasserin  |4 aut 
700 1 |a Kassam, Farzaan  |e verfasserin  |4 aut 
700 1 |a Grawe, Brian M  |e verfasserin  |4 aut 
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