Dataset Information

Patients Undergoing Shoulder Stabilization Surgery Have Elevated Shoulder Activity Compared With Sex- and Age-Matched Healthy Controls.

ABSTRACT:

Background

Shoulder activity level may be a risk factor for shoulder instability, an indication for surgical intervention, and a risk factor for failure of operative stabilization.

Hypothesis

Patients undergoing shoulder stabilization surgery have a higher activity level compared with sex- and age-matched healthy controls.

Study design

Cross-sectional study.

Level of evidence

Level 2.

Methods

Patients undergoing shoulder stabilization surgery aged 18 to 50 years were prospectively enrolled. As part of data collection, patients completed a previously validated shoulder activity scale, which generates a score reporting frequency of activity ranging from 0 (least active) to 20 (most active). The activity level of these patients was compared with sex- and age-matched norms for a healthy population with no history of shoulder disorders.

Results

A total of 409 subjects (343 male, 66 female) undergoing shoulder instability surgery completed the activity scale. Seventy-seven percent of patients had higher shoulder activity level than sex- and age-matched controls. Seventy-nine percent aged 18 to 30 years had a higher shoulder activity level than controls, with an identical distribution for men (79%) and women (79%). Among patients aged 31 to 50 years, 70% had higher activity than controls. However, men were more likely to have a higher activity level than controls (72%) versus women (59%). In patients aged 18 to 30 years, median activity level for instability patients was 14 in men compared with 10 in controls, and 13 in women compared with 8 in controls. In patients aged 31 to 50 years, median activity level was 13 in men compared with 10 in controls and 10 in women compared with 8 in controls.

Conclusion

Patients undergoing shoulder stabilization surgery have a higher activity level than sex- and age-matched healthy controls.

Clinical relevance

Shoulder activity is especially elevated in younger, male instability patients.

SUBMITTER: Brophy RH

PROVIDER: S-EPMC5315263 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Patients Undergoing Shoulder Stabilization Surgery Have Elevated Shoulder Activity Compared With Sex- and Age-Matched Healthy Controls.

Brophy Robert H RH Hettrich Carolyn M CM Ortiz Shannon S Wolf Brian R BR

Sports health 20161102

<h4>Background</h4>Shoulder activity level may be a risk factor for shoulder instability, an indication for surgical intervention, and a risk factor for failure of operative stabilization.<h4>Hypothesis</h4>Patients undergoing shoulder stabilization surgery have a higher activity level compared with sex- and age-matched healthy controls.<h4>Study design</h4>Cross-sectional study.<h4>Level of evidence</h4>Level 2.<h4>Methods</h4>Patients undergoing shoulder stabilization surgery aged 18 to 50 yea ...[more]

PMID: 27807259

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Project description:PurposeTo assess independent predictors of surgery after an emergency department visit for shoulder instability, including patient-related and socioeconomic factors.MethodsPatients presenting to the emergency department were identified in the New York Statewide Planning and Research Cooperative System database from 2015 to 2018 by International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis codes for anterior shoulder dislocation or subluxation. All shoulder stabilization procedures in the outpatient setting were identified using Current Procedural Terminology codes (23455, 23460, 23462, 23466, and 29806). A multivariable logistic regression was performed to assess the impact of patient factors on the likelihood of receiving surgery. The variables included in the analysis were age, sex, race, social deprivation, Charlson Comorbidity Index, recurrent dislocation, and primary insurance type.ResultsIn total, 16,721 patients with a shoulder instability diagnosis were included in the analysis and 1,028 (6.1%) went on to have surgery. Patients <18 years old (odds ratio [OR] 8.607, P < .0001), those with recurrent dislocations (OR 2.606, P < .0001), or worker's compensation relative to private insurance (OR 1.318, P = .0492) had increased odds of receiving surgery. Hispanic (OR 0.711, P = .003) and African American (OR 0.63, P < .0001) patients had decreased odds of surgery compared with White patients. Patients with Medicaid (OR 0.582, P < .0001) or self-pay (OR 0.352, P < .0001) insurance had decreased odds of undergoing surgery relative to privately insured patients. Patients with greater levels of social deprivation (OR 0.993, P < .0001) also were associated with decreased odds of surgery.ConclusionsAnterior glenohumeral instability and subsequent stabilization surgery is associated with disparities among patient race, primary insurance, and social deprivation.Clinical relevanceConsidering the relationship between differential care and health disparities, it is critical to define and increase physician awareness of these disparities to help ensure equitable care.

Project description:PurposeThe purpose of this systematic review was to examine the effect that sex has on recurrence of anterior shoulder instability following primary arthroscopic anterior shoulder stabilization.MethodsA systematic review using PRISMA guidelines was performed by searching PubMed, Embase and Cochrane Library databases to identify studies reporting recurrence rates following arthroscopic anterior shoulder stabilization with a minimum follow-up period of 2 years. Patient demographics as well as preoperative, intraoperative and postoperative findings, including patient-reported outcomes and recurrence rates, were analyzed by 2 independent reviewers. Recurrence was defined as an episode of dislocation, subluxation or instability following primary arthroscopic anterior shoulder stabilization. Study methodological quality was evaluated with the Modified Coleman Methodology Score (MCMS). Risk bias was evaluated using the Methodological Index for Non-randomized Studies (MINORS score). Descriptive statistics are presented.ResultsTen studies (1 Level I, 1 Level II, 5 Level III, and 3 Level IV), including a total of 7,102 patients with primary traumatic and/or recurrent traumatic shoulder instability without previous procedures who underwent primary arthroscopic anterior shoulder stabilization, were included (mean follow-up, 34.6 months; mean age, 25.4 years). There was a total of 5,097 males (71.8%) and 2,005 females (28.2%). There was a higher recurrence rate in males (6%-37%) compared to females (0-32%). Clinical outcomes were inconsistently reported, so no quantitative analysis of clinical outcomes or return-to-sport between sexes was possible. The average MCMS of all 10 studies was 76.8 ± 8.0, indicating good methodology.ConclusionsMales may have higher recurrence rates than females following primary arthroscopic anterior shoulder stabilization; however, the heterogeneity of the included studies precludes any definitive conclusions.Level of evidenceIV, Systematic Review of Level I-IV.

Dataset Information

Patients Undergoing Shoulder Stabilization Surgery Have Elevated Shoulder Activity Compared With Sex- and Age-Matched Healthy Controls.

Background

Hypothesis

Study design

Level of evidence

Methods

Results

Conclusion

Clinical relevance

Publications

Patients Undergoing Shoulder Stabilization Surgery Have Elevated Shoulder Activity Compared With Sex- and Age-Matched Healthy Controls.

Similar Datasets

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