PMID- 37690587
OWN - NLM
STAT- MEDLINE
DCOM- 20240318
LR  - 20240318
IS  - 1532-6500 (Electronic)
IS  - 1058-2746 (Linking)
VI  - 33
IP  - 4
DP  - 2024 Apr
TI  - Does achieving clinically important thresholds after first shoulder arthroplasty 
      predict similar outcomes of the contralateral shoulder?
PG  - 880-887
LID - S1058-2746(23)00650-X [pii]
LID - 10.1016/j.jse.2023.08.004 [doi]
AB  - BACKGROUND: Patients are increasingly undergoing bilateral total shoulder 
      arthroplasty (TSA). At present, it is unknown whether success after the first TSA 
      is predictive of success after contralateral TSA. We aimed to determine whether 
      exceeding clinically important thresholds of success after primary TSA predicts 
      similar outcomes for subsequent contralateral TSA. METHODS: We performed a 
      retrospective review of a prospectively collected shoulder arthroplasty database 
      for patients undergoing bilateral primary anatomic (aTSA) or reverse (rTSA) total 
      shoulder arthroplasty since January 2000 with preoperative and 2- or 3-year 
      clinical follow-up. Our primary outcome was whether exceeding clinically 
      important thresholds in the American Shoulder and Elbow Surgeons Standardized 
      Shoulder Assessment Form (ASES) score for the first TSA was predictive of similar 
      success of the contralateral TSA; thresholds for the ASES score were adopted from 
      prior literature and included the minimal clinically important difference (MCID), 
      the substantial clinical benefit (SCB), 30% of maximal possible improvement 
      (MPI), and the patient acceptable symptomatic state (PASS). The PASS is defined 
      as the highest level of symptom beyond which patients consider themselves well, 
      which may be a better indicator of a patient's quality of life. To determine 
      whether exceeding clinically important thresholds was independently predictive of 
      similar success after second contralateral TSA, we performed multivariable 
      logistic regression adjusted for age at second surgery, sex, BMI, and type of 
      first and second TSA. RESULTS: Of the 134 patients identified that underwent 
      bilateral shoulder arthroplasty, 65 (49%) had bilateral rTSAs, 45 (34%) had 
      bilateral aTSAs, 21 (16%) underwent aTSA/rTSA, and 3 (2%) underwent rTSA/aTSA. On 
      multivariable logistic regression, exceeding clinically important thresholds 
      after first TSA was not associated with greater odds of achieving thresholds 
      after second TSA when success was evaluated by the MCID, SCB, and 30% MPI. In 
      contrast, exceeding the PASS after first TSA was associated with 5.9 times 
      greater odds (95% confidence interval 2.5-14.4, P < .001) of exceeding the PASS 
      after second TSA. Overall, patients who exceeded the PASS after first TSA 
      exceeded the PASS after second TSA at a higher rate (71% vs. 29%, P < .001); this 
      difference persisted when stratified by type of prosthesis for first and second 
      TSA. CONCLUSIONS: Patients who achieve the ASES score PASS after first TSA have 
      greater odds of achieving the PASS for the contralateral shoulder regardless of 
      prostheses type.
CI  - Published by Elsevier Inc.
FAU - Turnbull, Lacie M
AU  - Turnbull LM
AD  - Department of Orthopaedic Surgery and Sports Medicine, University of Florida, 
      Gainesville, FL, USA.
FAU - Hao, Kevin A
AU  - Hao KA
AD  - College of Medicine, University of Florida, Gainesville, FL, USA.
FAU - Srinivasan, Ramesh C
AU  - Srinivasan RC
AD  - The Hand Center of San Antonio, San Antonio, TX, USA.
FAU - Wright, Jonathan O
AU  - Wright JO
AD  - Department of Orthopaedic Surgery and Sports Medicine, University of Florida, 
      Gainesville, FL, USA.
FAU - Wright, Thomas W
AU  - Wright TW
AD  - Department of Orthopaedic Surgery and Sports Medicine, University of Florida, 
      Gainesville, FL, USA.
FAU - Farmer, Kevin W
AU  - Farmer KW
AD  - Department of Orthopaedic Surgery and Sports Medicine, University of Florida, 
      Gainesville, FL, USA.
FAU - Vasilopoulos, Terrie
AU  - Vasilopoulos T
AD  - Department of Orthopaedic Surgery and Sports Medicine, University of Florida, 
      Gainesville, FL, USA; Department of Anesthesiology, University of Florida, 
      Gainesville, FL, USA.
FAU - Struk, Aimee M
AU  - Struk AM
AD  - Department of Orthopaedic Surgery and Sports Medicine, University of Florida, 
      Gainesville, FL, USA.
FAU - Schoch, Bradley S
AU  - Schoch BS
AD  - Department of Orthopaedic Surgery, Mayo Clinic, Jacksonville, FL, USA.
FAU - King, Joseph J
AU  - King JJ
AD  - Department of Orthopaedic Surgery and Sports Medicine, University of Florida, 
      Gainesville, FL, USA. Electronic address: kingjj@ortho.ufl.edu.
LA  - eng
PT  - Journal Article
DEP - 20230909
PL  - United States
TA  - J Shoulder Elbow Surg
JT  - Journal of shoulder and elbow surgery
JID - 9206499
SB  - IM
MH  - Humans
MH  - Shoulder/surgery
MH  - *Arthroplasty, Replacement, Shoulder
MH  - *Shoulder Joint/diagnostic imaging/surgery
MH  - Treatment Outcome
MH  - Quality of Life
MH  - Retrospective Studies
MH  - Range of Motion, Articular
OTO - NOTNLM
OT  - Shoulder replacement
OT  - aTSA
OT  - anatomic total shoulder arthroplasty
OT  - clinical outcome
OT  - inverted shoulder
OT  - rTSA
OT  - reverse shoulder arthroplasty
OT  - reverse total shoulder arthroplasty
EDAT- 2023/09/11 00:42
MHDA- 2024/03/18 06:42
CRDT- 2023/09/10 19:25
PHST- 2023/03/29 00:00 [received]
PHST- 2023/07/30 00:00 [revised]
PHST- 2023/08/06 00:00 [accepted]
PHST- 2024/03/18 06:42 [medline]
PHST- 2023/09/11 00:42 [pubmed]
PHST- 2023/09/10 19:25 [entrez]
AID - S1058-2746(23)00650-X [pii]
AID - 10.1016/j.jse.2023.08.004 [doi]
PST - ppublish
SO  - J Shoulder Elbow Surg. 2024 Apr;33(4):880-887. doi: 10.1016/j.jse.2023.08.004. 
      Epub 2023 Sep 9.