Abstract
BackgroundUnderstanding the pattern of recovery and expected rate of change after shoulder arthroplasty is helpful to clinicians and patients for setting realistic expectations and goals. The purpose of this study was to describe the pattern of recovery over a 2-year period for patients receiving either a Total Shoulder Arthroplasty (TSA) or Humeral Head Replacement (HHR).MethodsThis was a secondary analysis of prospectively collected data of patients who had undergone TSA or HHR and were followed for up to 2 years. Patients were seen prior to surgery and at 6 months, one year and two years after surgery and completed the American Shoulder and Elbow Surgeon’s (ASES) questionnaire, Relative Constant Murley score (RCMS) and underwent range of motion and strength assessment.ResultsData of 134 patients who had surgery from April 2001 to July 2011 were used for analysis. One hundred and eight patients underwent TSA (81%) and 26 (19%) had HHR. Both surgeries were associated with a statistically significant improvement in physical symptoms, ASES, RCMS, range of motion and strength (p <0.0001). The greatest change for all outcomes occurred within the first 6-months of surgery. Improvement in ASES, RCMS continued up to 12-months and then plateaued. Improvement in physical symptoms leveled off at 6-months in the HHR group but continued up to 12-months in the TSR group. Strength showed improvement in both groups up to 24-months post-surgery.ConclusionBoth TSA and HHR groups showed a statistically significant improvement in perceived disability, range of motion and strength over two years with the greatest improvement made by 6 months. The recovery profiles for the surgeries showed different patterns.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-306) contains supplementary material, which is available to authorized users.
Highlights
Understanding the pattern of recovery and expected rate of change after shoulder arthroplasty is helpful to clinicians and patients for setting realistic expectations and goals
Three patients died of causes not related to shoulder arthroplasty
The Neer II prosthesis was used in 18 patients with 49 patients receiving the Bigliani-Flatow (BF) prosthesis and 41 receiving the Total Evolutive Shoulder System (TESS)
Summary
Understanding the pattern of recovery and expected rate of change after shoulder arthroplasty is helpful to clinicians and patients for setting realistic expectations and goals. The purpose of this study was to describe the pattern of recovery over a 2-year period for patients receiving either a Total Shoulder Arthroplasty (TSA) or Humeral Head Replacement (HHR). Total Shoulder Arthroplasty (TSA) is the treatment of choice for primary and posttraumatic osteoarthritis and some inflammatory conditions of procedures [6,7]. These studies showed that total shoulder arthroplasty provided better functional outcomes than hemiarthroplasty for patients with primary osteoarthritis of the shoulder. The limitation of the available research is lack of information on important time points which helps to predict when patients reach their maximal recovery as measured by patient reported measures of pain and disability or functional abilities including range of motion and strength
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