PMID- 36353437
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221111
IS  - 2666-6383 (Electronic)
IS  - 2666-6383 (Linking)
VI  - 6
IP  - 6
DP  - 2022 Nov
TI  - Travel distance does not affect outcomes after total shoulder arthroplasty.
PG  - 903-909
LID - 10.1016/j.jseint.2022.08.001 [doi]
AB  - BACKGROUND: The purpose of this investigation was to determine the effect of 
      travel distance on achieving the minimal clinically important difference (MCID) 
      on all three commonly used patient-reported outcome measures (PROMs) for the 
      shoulder more than 1 year following total shoulder arthroplasty (TSA). METHODS: 
      Patients undergoing reverse or anatomic TSA at a high-volume tertiary referral 
      center between September 2016 and August 2018 were retrospectively reviewed. 
      Patients were divided into 2 groups: driving distance of >50 miles from the 
      location of surgery (referral group) and driving distance of <50 miles (local 
      group). Scores on preoperative and postoperative PROMs, including American 
      Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation 
      (SANE) score, and Constant Score (CS) at minimum 1-year follow-up were assessed. 
      Chi-square analysis was used to analyze the achievement of MCID on any PROM or a 
      combination of PROMs. Logistic regression was performed to determine whether 
      travel distance and other variables of interest had an effect on achieving MCID 
      on all three PROMs. RESULTS: A total of 214 patients with minimum 1-year 
      follow-up were included in the final analysis. Of these, 165 patients (77.1%) 
      traveled <50 miles to their orthopedic provider at the time of surgery. The local 
      group demonstrated significantly inferior preoperative SANE scores (P < .001) and 
      significantly higher postoperative ASES scores (P = .001). A total of 166 (77%) 
      patients achieved all three MCIDs postoperatively. There was no significant 
      difference between distance groups for achievement of all MCIDs (P = .328). On 
      multivariable regression, body mass index > 30 (odds ratio [OR], 5.78; 95% 
      confidence interval [CI], 1.53-30.28), worker's compensation status (OR, 16.78; 
      95% CI, 2.34-161.39), and higher preoperative ASES score (OR, 1.04; 95% CI, 
      1.01-1.07) were associated with an increased risk of failure to achieve all MCIDs 
      (P < .05). Age, adjusted gross income, private insurance, and travel distance 
      were not significantly associated with failure to achieve all MCIDs. CONCLUSIONS: 
      After controlling for age, sex, and adjusted gross income, distance traveled to a 
      high-volume referral center did not have an effect on achieving the MCID on all 
      three commonly used PROMs for the shoulder at least 1 year after undergoing TSA. 
      Elevated body mass index, worker's compensation status, and higher preoperative 
      ASES score were associated with an increased risk of failure to achieve all MCIDs 
      after TSA.
CI  - (c) 2022 The Author(s).
FAU - Mehta, Nabil
AU  - Mehta N
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Lavoie-Gagne, Ophelie Z
AU  - Lavoie-Gagne OZ
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Diaz, Connor C
AU  - Diaz CC
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Cohn, Matthew R
AU  - Cohn MR
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Garrigues, Grant E
AU  - Garrigues GE
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Nicholson, Gregory P
AU  - Nicholson GP
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Verma, Nikhil N
AU  - Verma NN
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Forsythe, Brian
AU  - Forsythe B
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
LA  - eng
PT  - Journal Article
DEP - 20220817
PL  - United States
TA  - JSES Int
JT  - JSES international
JID - 101763461
PMC - PMC9637794
OTO - NOTNLM
OT  - Distance traveled
OT  - Minimal clinically important difference
OT  - Patient-reported outcomes
OT  - Reverse total shoulder arthroplasty
OT  - Total shoulder arthroplasty
OT  - Value-based care
EDAT- 2022/11/11 06:00
MHDA- 2022/11/11 06:01
PMCR- 2022/08/17
CRDT- 2022/11/10 02:17
PHST- 2022/11/10 02:17 [entrez]
PHST- 2022/11/11 06:00 [pubmed]
PHST- 2022/11/11 06:01 [medline]
PHST- 2022/08/17 00:00 [pmc-release]
AID - S2666-6383(22)00168-2 [pii]
AID - 10.1016/j.jseint.2022.08.001 [doi]
PST - epublish
SO  - JSES Int. 2022 Aug 17;6(6):903-909. doi: 10.1016/j.jseint.2022.08.001. 
      eCollection 2022 Nov.