Survey of Expert Opinion Regarding Peri-operative Management of Shoulder Arthroplasty

Document Type : LETTER TO THE EDITOR

Authors

1 Department of Orthopaedic and Plastic Surgery, Wright State University Boonshoft School of Medicine, Dayton, Ohio, USA

2 Department of Orthopaedic and Plastic Surgery, Wright State University Boonshoft School of Medicine, Dayton, Ohio, Dayton, Ohio, USA

3 University of Kansas School of Medicine, USA

4 1 Department of Orthopaedic and Plastic Surgery, Wright State University Boonshoft School of Medicine, Dayton, Ohio, USA- 3 Department of Kinesiology and Health, Wright State University, Dayton, Ohio, USA

5 Johns Hopkins University, Baltimore, USA

6 5 Dayton Veterans Affairs Medical Center, Dayton, Ohio, USA- 6 University of Buffalo, Buffalo, USA

Abstract

Total shoulder arthroplasty surgeries have continued to increase in popularity with a concomitant expansion of the indications for these procedures. The purpose of our study is to evaluate the global perioperative treatment of these patients, from preoperative optimization and patient selection through postoperative therapy regimens.
We electronically sent a survey to the members of the American Society of Shoulder and Elbow surgeons that queried surgeons on several important elements in the global care of shoulder arthroplasty patients. Questions were designed to evaluate common preoperative, intraoperative, and postoperative treatment decisions. Only 3 out of 24 questions (12.5%) reached the 75% large majority mark, with five questions (20.8%) failing to reach a majority response. An additional 3 questions failed to show any significant answer distribution. This variability among shoulder practices likely represents a fairly surgeon-specific treatment algorithm currently. This may correspond to a lack of robust, evidence-based guidelines.
Level of evidence: Level IV
Keywords: Total shoulder arthroplasty; preoperative optimization; postoperative rehabilitation

Keywords


1. Management of Glenohumeral Joint Osteoarthritis, 
Evidence-Based Clinical Practice Guideline.American 
Academy of Orthopaedic Surgeons (AAOS). Available 
at: https://www.aaos.org/gjocpg. Accessed March 23, 
2020