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Different expectations found between men, women for outcomes in TSA
Men chose exercise, sports participation while women chose daily activities as top expectations.
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While men and women experienced similar functional outcomes after total shoulder arthroplasty, they had different expectations and reasons for pursuing a total shoulder arthroplasty, according to study results.
“There is no difference in the outcomes between men and women, but the expectations are different,” Andrew Jawa, MD, an orthopedic surgeon at New England Baptist Hospital and assistant professor at Tufts University School of Medicine, told Orthopedics Today. “Men value sports participation more than women in terms of what they are able to do with their shoulder afterward, while [for] women, their most important expectation is to do certain daily activities and chores and both value sleep at a very high rate, meaning their sleep was disturbed fairly significantly by shoulder arthritis.”
Different expectations
Jawa and his colleagues measured functional outcomes of 63 patients who underwent total shoulder arthroplasty (TSA) between 2007 and 2010. These measures included American Shoulder and Elbow Surgeons (ASES) and SF-12 Health Survey scores. All patients filled out a preoperative survey on three expectations they most hoped to gain from surgery.
When it came to expectations, results showed men chose the ability to exercise or participate in sports as their top expectation while women chose to be able to independently perform household chores and daily routine. However, researchers noted both men and women chose the ability to sleep through the night as their second expectation.
Overall, both men and women had a high and similar percentage of achievement for each expectation, as well as significant improvement in ASES and SF-12 scores at a minimum of 3 years. Researchers found no significant differences in absolute scores or change in scores for ASES and SF-12 between groups.
“The main implication is that it gets into a deeper question of how expectations can affect outcomes, and there is data that supports expectation can change the outcomes in TSA,” Jawa said. “In this case there was no difference, but it makes us recognize that we have to be more acutely aware of what our patients are expecting and maybe to look at it on a scientific basis in a deeper way.”
Future research
According to Jawa, future research should look at differences in outcomes between men and women after reverse shoulder arthroplasty, as well as what expectations patients have for sports and activity levels after TSA or reverse TSA and how patients actually end up performed after the procedure.
“There is a big push in the NIH to look at gender differences,” Jawa said. “I think there needs to be more research consisting how the different genders respond differently to different surgeries, different devices [and] different medications.” – by Casey Tingle
- Reference:
- Jawa A, et al. J Shoulder Elbow Surg. 2016;doi:10.1016/j.jse.2016.03.003.
- For more information:
- Andrew Jawa, MD, can be reached at New England Baptist Hospital, 840 Winter St., Waltham, MA 02451; email: andrewjawa@gmail.com.
Disclosure: Jawa reports he is a consultant for DJO Global.