What are the costs of glenohumeral osteoarthritis in the year prior to a total shoulder arthroplasty (TSA)?

Abstract Background Glenohumeral osteoarthritis can, in the most severe cases, require surgery with insertion of a shoulder arthroplasty. A design with a stem in the humeral bone canal is currently regarded as the standard treatment option in patients who have an intact rotator cuff function, but complications related to the stem including humeral fractures can have devastating consequences. By using a stemless humeral component, stem-related complications can be reduced. The aim of this study is to compare the Comprehensive Nano stemless total shoulder arthroplasty (intervention group) with the Comprehensive stemmed total shoulder arthroplasty (control group). Materials and methods This is a randomized controlled trial comparing the stemless and the stemmed total shoulder arthroplasty. All Danish citizens with glenohumeral osteoarthritis indicating a total shoulder arthroplasty referred to the orthopedic department at Copenhagen University Hospital in Herlev/Gentofte will be offered participation. The following exclude from participation: below 18 years of age, cognitive or linguistic impairment, insufficient function of the rotator cuff, poor bone quality, and ASA groups 4–5. A total of 122 patients will be included of which 56 will be part of a radiostereometric analysis (RSA) study of humeral component migration. The primary outcomes are magnitude of migration of the humeral component assessed by RSA and patient-reported outcome by Western Ontario Osteoarthritis of the Shoulder index (WOOS). The secondary outcomes are additional patient-reported outcomes, functional outcome, readmission, complications, revisions, and changes in bone mineral density (BMD) of the proximal humerus assessed by duel energy x-ray absorptiometry (DXA) and economy (cost-utility analysis). The patients are examined before the operation and 3, 6, 12, and 24 months postoperative. Discussion To our knowledge, RSA has never been used to access migration of a stemmed or a stemless humeral component nor has the stemmed and the stemless humeral component been compared with regard to pain relief and shoulder function in a randomized clinical trial. Today, the two designs are considered equal in the treatment of osteoarthritis. The study will provide surgeons and patients with information about shoulder arthroplasty for osteoarthritis and assist them in decision-making. Trial registration ClinicalTrials.gov NCT04105478. Registered on 25 September 2019

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A Preoperative Educational Video Improves Patient Satisfaction and Perceived Knowledge, but Not Patient Understanding for Total Shoulder Arthroplasty: A Randomized, Surgeon-Blinded Study

Journal of Shoulder and Elbow Arthroplasty ◽

10.1177/2471549218792966 ◽

2018 ◽

Vol 2 ◽

pp. 247154921879296 ◽

Cited By ~ 2

Author(s):

Sydney M Fasulo ◽

Edward J Testa ◽

Sarah M Lawler ◽

Megan Fitzgerald ◽

Jeremiah T Lowe ◽

...

Keyword(s):

Treatment Group ◽

Shoulder Arthroplasty ◽

Total Shoulder Arthroplasty ◽

Educational Video ◽

Patient Counseling ◽

Patient Understanding ◽

P 75 ◽

Blinded Study ◽

Glenohumeral Osteoarthritis ◽

Video Group

Background The complexity of total joint arthroplasty warrants significant patient counseling, and some surgeons are utilizing multimedia to aid in preoperative education. Our aim was to assess the effect of an educational video on patient understanding and satisfaction when supplementing a traditional office consultation for total shoulder arthroplasty. Methods This study was a surgeon-blinded, randomized control trial involving 60 consecutive patients undergoing primary total shoulder arthroplasty. Following a preoperative consultation by a single surgeon, patients were randomized in a 1:1 ratio to either a control or treatment group. All participants received a 9-question true-or-false test pertaining to basic shoulder arthroplasty knowledge. The treatment group subsequently viewed a 13-minute educational video explaining glenohumeral osteoarthritis, surgery, and postoperative expectations. At a second preoperative appointment, participants of both groups were asked to repeat the same test. Results Fifty-two patients were available for the second preoperative appointment. There was no difference in test scores between the video (7.84/9) and no video (7.89/9) groups ( P = .75). All patients in the video group reported improved satisfaction and understanding. Conclusion Patients who watched an educational video supplementing a preoperative consultation for shoulder arthroplasty reported improved satisfaction but did not demonstrate increased understanding compared to those receiving a standard preoperative consultation.

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