PMID- 37277489
OWN - NLM
STAT- MEDLINE
DCOM- 20231116
LR  - 20231116
IS  - 1432-1068 (Electronic)
IS  - 1633-8065 (Linking)
VI  - 33
IP  - 8
DP  - 2023 Dec
TI  - Patients with poor early clinical outcomes after anatomic total shoulder 
      arthroplasty have sustained poor performance at 2 years from surgery.
PG  - 3661-3669
LID - 10.1007/s00590-023-03585-z [doi]
AB  - PURPOSE: We sought to define the risk of persistent shoulder dysfunction after 
      anatomic total shoulder arthroplasty (aTSA) beyond the early postoperative period 
      and identify risk factors for persistent poor performance. METHODS: We 
      retrospectively identified 144 primary aTSAs performed for primary osteoarthritis 
      with early poor performance and 2-year minimum follow-up. Early poor performance 
      was defined as a postoperative ASES score below the 20th percentile at 3- or 
      6-months (62 and 72 points, respectively). Persistent poor performance at 2 years 
      was defined as failing to achieve the patient acceptable symptomatic state (PASS) 
      [ASES = 81.7 points]. RESULTS: At 2-year follow-up, 51% (n = 74) of patients with 
      early poor performance at either 3- or 6-month follow-up had persistent poor 
      performance. There was no difference in the rate of persistent poor performance 
      if patients were poor performers at the 3-, 6-month follow-up, or both (50% vs. 
      49% vs. 56%, P = .795). Of aTSAs achieving the PASS at 2-year follow-up, a 
      greater proportion exceeded the minimal clinically important differences (MCID) 
      [Forward elevation, external rotation, and all outcome scores] and substantial 
      clinical benefit (SCB) [external rotation and all outcome scores] compared to 
      persistent poor performers. However, over half of persistent poor performers 
      still exceeded the MCID for all outcome measures (56-85%). Independent predictors 
      of persistent poor performance were hypertension (2.61 [1.01-6.72], P = .044) and 
      diabetes (5.14 [1.00-26.4], P = .039). CONCLUSION: Over half of aTSAs with an 
      ASES score < 20th percentile at early follow-up had continued poor shoulder 
      function at 2-years postoperatively. Persistent poor performance was best 
      projected by preoperative hypertension and diabetes. LEVEL OF EVIDENCE: Level 
      III; Retrospective Cohort Comparison using Large Database; Treatment Study.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, 
      part of Springer Nature.
FAU - Marigi, Erick M
AU  - Marigi EM
AD  - Department of Orthopaedic Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, 
      FL, 32224, USA.
FAU - Hao, Kevin A
AU  - Hao KA
AD  - College of Medicine, University of Florida, Gainesville, FL, USA.
FAU - Tams, Carl
AU  - Tams C
AD  - Exactech, Inc., Gainesville, FL, USA.
FAU - Wright, Jonathan O
AU  - Wright JO
AD  - Department of Orthopaedic Surgery & Sports Medicine, University of Florida, 
      Gainesville, FL, USA.
FAU - Wright, Thomas W
AU  - Wright TW
AD  - Department of Orthopaedic Surgery & Sports Medicine, University of Florida, 
      Gainesville, FL, USA.
FAU - King, Joseph J
AU  - King JJ
AD  - Department of Orthopaedic Surgery & Sports Medicine, University of Florida, 
      Gainesville, FL, USA.
FAU - Werthel, Jean-David
AU  - Werthel JD
AD  - Department of Orthopedic Surgery, Hopital Ambroise Pare, Boulogne-Billancourt, 
      France.
FAU - Schoch, Bradley S
AU  - Schoch BS
AUID- ORCID: 0000-0002-9355-5069
AD  - Department of Orthopaedic Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, 
      FL, 32224, USA. schoch.bradley@mayo.edu.
LA  - eng
PT  - Journal Article
DEP - 20230605
PL  - France
TA  - Eur J Orthop Surg Traumatol
JT  - European journal of orthopaedic surgery & traumatology : orthopedie traumatologie
JID - 9518037
SB  - IM
MH  - Humans
MH  - *Arthroplasty, Replacement, Shoulder/adverse effects
MH  - Retrospective Studies
MH  - *Shoulder Joint/surgery
MH  - Treatment Outcome
MH  - *Diabetes Mellitus
MH  - *Hypertension/surgery
MH  - Range of Motion, Articular
OTO - NOTNLM
OT  - Anatomical shoulder arthroplasty
OT  - Poor outcome
OT  - Shoulder replacement
OT  - Underperformer
EDAT- 2023/06/06 01:11
MHDA- 2023/11/16 06:44
CRDT- 2023/06/05 23:19
PHST- 2023/03/15 00:00 [received]
PHST- 2023/05/10 00:00 [accepted]
PHST- 2023/11/16 06:44 [medline]
PHST- 2023/06/06 01:11 [pubmed]
PHST- 2023/06/05 23:19 [entrez]
AID - 10.1007/s00590-023-03585-z [pii]
AID - 10.1007/s00590-023-03585-z [doi]
PST - ppublish
SO  - Eur J Orthop Surg Traumatol. 2023 Dec;33(8):3661-3669. doi: 
      10.1007/s00590-023-03585-z. Epub 2023 Jun 5.