2017 ISAKOS Biennial Congress Paper #35

 

What Do Patients Expect of Rotator Cuff Repair and Does it Matter

Mohamed A. Imam, MD, MSc, DSportMed, PhD, FRCS(Tr&Orth), Woodbridge, Suffolk UNITED KINGDOM
Vijay Ramasamy, FRCS Orth, London UNITED KINGDOM
Rupen Dattani, Cambridge UNITED KINGDOM
Mohamed Elsherbini, MSc, London UNITED KINGDOM
Vipul Patel, FRCS Orth, London UNITED KINGDOM

South West london Elective Orthopaedic Centre, London, UNITED KINGDOM

FDA Status Not Applicable

Summary

What do patients expect of rotator cuff repair and does it matte

Abstract

Purpose

The purpose of this study was to evaluate what patients expect from rotator cuff repair, the extent of fulfilment of preoperative expectations and to determine the relationship between expectations and Patient-reported outcome measures (PROMs) before and after surgery.

Methods

80 patients were surveyed prior to rotator cuff repair using the Hospital for Special Surgery Shoulder Surgery Expectations Survey, Oxford Shoulder Score (OSS) and Euroqol EQ5D. At 6 months and 2 years after surgery, patients completed a modified Shoulder Surgery Expectations Fulfilment Survey, OSS, EQ5D and satisfaction survey (0-100%). Preoperative and postoperative PROMs data were compared with paired t-tests. The relationship between preoperative expectations, postoperative expectations fulfilment and PROMs were examined using multiple logistic regression.

Results

OSS improved from a preoperative mean of 24.5 to 43.2 at 2 years (P<0.01); EQ5D improved from 0.47 preoperatively to 0.90 at final follow-up (P<0.01). Median postoperative satisfaction was 90%. Preoperatively over 80% of patients rated 8 of 17 expectations as “very” or “somewhat” important; at 6 months 5 of 8 important expectations and at 2 years all 8 important expectations were rated as fulfilled by over 80% of patients. The expectations of “relief of daytime and night-time pain”, “the shoulder to be the way it was before” and “improve range of movements” were ranked the highest prior to surgery. Patients’ preoperative expectations were not correlated with age, gender or preoperative PROMS nor did they predict postoperative PROMS. There was a statistically significant correlation between fulfilment of expectations after surgery and patient satisfaction.

Conclusions

Patients whose expectations of surgery are fulfilled achieve a high degree of satisfaction after rotator cuff repair. Patients may be reassured that surgery is successful in fulfilling expectations that are rated as important but it may take up to 2 years for these expectations to be met.