Online ArticlePsychosocial factors affecting outcomes after shoulder arthroplasty: a systematic review
Section snippets
Search strategy
A comprehensive literature search was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. One independent reviewer systematically searched the databases PubMed, Medline, Cochrane, Scopus, and Google Scholar. The following date range was used in the search engines: May 30, 2000, to May 30, 2019. The following combination of keywords was used for the search: “shoulder arthroplasty outcomes,” “psychosocial factors shoulder,” “shoulder
Study characteristics
There were 16 studies that met the inclusion criteria. Level of evidence, study design, clinical question answered, and average follow-up for each of the included studies are presented in Table I. The included studies looked at outcomes after revision and primary cases. The study population underwent either TSA or rTSA. Psychosocial factors influencing shoulder arthroplasty outcomes included preoperative opioid use, preoperative patient expectations, diagnosis of depression, anxiety, or other
Discussion
Our analysis reveals that pre-existing diagnosis of a mental health disorder, an active WC claim, and preoperative opioid use are correlated with lower patient-reported postoperative outcome scores after shoulder arthroplasty compared with unaffected controls.25,32, 33, 34,50,51 These results are similar to outcome studies in hip and knee arthroplasty. Duivenvoorden et al12 showed that patients with preoperative anxiety and depressive symptoms had worse patient-reported outcomes and less
Conclusion
Our review suggests that preoperative diagnosis of mental health disorders, WC status, preoperative opioid use, patients' expectations and confidence level, patients' resilience, health insurance status, and amount of manual labor required for work all affect patient-reported postoperative outcomes after TSA. Psychosocial factors may play just as important, if not more, a role in affecting patient outcomes after TSA as technical factors.
Disclaimer
The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
References (53)
- et al.
Predicting dissatisfaction after total hip arthroplasty: a study of 850 patients
J Arthroplasty
(2011) - et al.
The influence of psychiatric comorbidity on perioperative outcomes after shoulder arthroplasty
J Shoulder Elbow Surg
(2014) - et al.
Predictors of early complications of total shoulder arthroplasty
J Arthroplasty
(2014) - et al.
Total shoulder arthroplasty: long-term survivorship, functional outcome, and quality of life
J Shoulder Elbow Surg
(2005) - et al.
Outcomes of anatomic total shoulder arthroplasty in patients with excessive glenoid retroversion: a case-control study
J Shoulder Elbow Surg
(2019) - et al.
Anxiety and depressive symptoms before and after total hip and knee arthroplasty: a prospective multicentre study
Osteoarthritis Cartilage
(2013) - et al.
2013 Neer Award: predictors of failure of nonoperative treatment of chronic, symptomatic, full-thickness rotator cuff tears
J Shoulder Elbow Surg
(2016) - et al.
Long-term results of reverse total shoulder arthroplasty for rotator cuff dysfunction: a systematic review of longitudinal outcomes
J Shoulder Elbow Surg
(2019) - et al.
Risks of loosening of a prosthetic glenoid implanted in retroversion
J Shoulder Elbow Surg
(2006) - et al.
Patient reported allergies are a risk factor for poor outcomes in total hip and knee arthroplasty
J Arthroplasty
(2014)
Current methods of the US Preventive Services Task Force: a review of the process
Am J Prev Med
Comparison of satisfied and dissatisfied patients 2 to 5 years after anatomic total shoulder arthroplasty
J Shoulder Elbow Surg
Anatomic total shoulder arthroplasty for patients receiving workers' compensation
J Shoulder Elbow Surg
Primary reverse shoulder arthroplasty using contemporary implants is associated with very low reoperation rates
J Shoulder Elbow Surg
Outcomes after shoulder replacement: comparison between reverse and anatomic total shoulder arthroplasty
J Shoulder Elbow Surg
Midterm results of a total shoulder prosthesis fixed with a cementless glenoid component
J Shoulder Elbow Surg
Workers' compensation claims and outcomes after reverse shoulder arthroplasty
J Shoulder Elbow Surg
Preoperative opioid use and outcomes after reverse shoulder arthroplasty
J Shoulder Elbow Surg
Preoperative opioid use associated with worse outcomes after anatomic shoulder arthroplasty
J Shoulder Elbow Surg
Effect of preoperative patient expectations on outcomes after reverse total shoulder arthroplasty
J Shoulder Elbow Surg
Quantifying success after total shoulder arthroplasty: the minimal clinically important difference
J Shoulder Elbow Surg
Greater patient confidence yields greater functional outcomes after primary total shoulder arthroplasty
J Shoulder Elbow Surg
Resilience correlates with outcomes after total shoulder arthroplasty
J Shoulder Elbow Surg
Total shoulder arthroplasty with the Neer prosthesis: long-term results
J Shoulder Elbow Surg
Treatment of extensor tendon disruption after total knee arthroplasty: a systematic review
J Arthroplasty
Psychological factors affecting the outcome of total hip and knee arthroplasty: a systematic review
Semin Arthritis Rheum
Cited by (41)
History of mood and anxiety disorders affects return to work and return to sports after rotator cuff repair
2024, Revue de Chirurgie Orthopedique et TraumatologiqueHistory of mood and anxiety disorders affects return to work and return to sports after rotator cuff repair
2024, Orthopaedics and Traumatology: Surgery and ResearchTotal shoulder arthroplasty in patients with dementia or mild cognitive impairment
2024, JSES InternationalInfluence of acromioclavicular joint arthritis on outcomes after reverse total shoulder
2024, JSES InternationalShoulder arthroplasty outcomes in patients with major depressive disorder or generalized anxiety disorder
2023, Seminars in Arthroplasty JSES
This systematic review of the literature did not require the approval of the Biomedical Institutional Review Board of The Ohio State University.