Shoulder arthroplasty patients satisfied with results

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Rheumawire

Mar 22, 2004

Shoulder arthroplasty patients satisfied with results

San Francisco, CA - Patients with primary osteoarthritis (OA) of the

shoulder who undergo total shoulder arthroplasty (TSA) are still

satisfied with the surgery results 10 to 20 years out, according to new

research presented at the 71st annual meeting of the American Academy of

Orthopaedic Surgeons (AAOS) [1].

In the study of OA patients who underwent TSA between 1982 and 1992, 73%

were enthusiastic about the procedurerating their results as

" excellent. " Another 20% said the procedure was " satisfactory, " and 7%

rated it as " unsatisfactory. "

Patients ranged in age from 40 to 76 years old at the time of TSA, with

an average age of 61. They were followed for an average of 13.2 years.

The researchers assessed outcome and satisfaction via several separate

measures.

Using Neer's criteria, an " excellent " result means that the patient has

no significant pain, enjoys full use of the shoulder, and regains normal

strength. A " satisfactory " result indicates that the patient has

occasional pain with activity and regains 30% of normal strength.

In the American Shoulder and Elbow Surgeons' scoring system, a total

score of 100 points includes 50 points for activities of daily living

and 50 points for pain. In the study, the average score among TSA

patients was 88 and the average visual-analog-scale (VAS) pain score was

1.07 on an ascending pain scale of 0 to 7.

" All patients were satisfied with their long-term results and would have

the procedure again, " says lead researcher Dr Rolando Izquierdo

(Columbia University, New York, NY).

According to the researchers, only 1 previous study has followed up with

OA patients to see whether the TSA decreased pain and increased

mobility. This study included patients with diagnoses in addition to OA

and thus showed less promising results, they point out.

In a separate study [2], researchers found that detection of orthopedic

implants rose from 10% before September 11, 2001 to more than 50%

afterward due to increased airport security.

In the study, Dr Piers Yates (Royal Bournemouth Hospital, Southhampton,

UK) found that overall, the detection rate varied and seemed to be based

on the type of implant. Specifically, patients with replacement hips

containing cobalt chrome almost always set the detector off, but

detection rates were inconsistent with other implants. About 70% of

people with orthopedic implants had not been told that their implants

could set off detectors.

The new study looked at 100 patients and 300 flights between 1996 and

2004 in European, Australian, Asian, and North and South American

airports.

Researchers suggest such patients carry an internationally recognized

joint-replacement card linked to a joint-registry database. This card

would adhere to the US Enhanced Border Security and Visa Reform Act of

2002 as well as the US Immigration and Naturalization Service's

requirement that all commercial airlines submit detailed passenger

manifests before arrival or departure.

The AAOS suggests that doctors offer implant patients a letter or a card

as proof of implant surgery as a way of dealing with airport security

checks.

Mann

Sources

1. Izquierdo, R, Kuremsky M, Voloshin I et al. Presentation: Long-term

follow-up of total shoulder arthroplasty for primary arthritis. San

Francisco, CA: American Academy of Orthopaedic Surgeons: 2004 meeting;

March 10-14, 2004:Paper 17 specialty day.

2. Yates, P, Middleton RG, and Plakogiannis C. Presentation: Metallic

implants used in orthopaedic surgery. Can they interfere with airport

security devices?. San Francisco, CA: American Academy of Orthopaedic

Surgeons: 2004 meeting; March 10-14, 2004:Poster no 368.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org