New research - Excellent patient satisfaction levels achieved after total shoulder replacement

Shoulder arthritis is not nearly as common as hip or knee arthritis, but it may be more common than you think. Patients with shoulder arthritis often present to our shoulder clinic because they have significant shoulder pain affecting sleep and basic activities of daily living. Non-surgical options are initiated to relieve night pain and improve symptoms; however, some patients with severe shoulder arthritis do progress to the point of needing a total shoulder replacement This is a study Dr. Morris and his team published in the Journal of Shoulder and Elbow Surgery.


Background: With an increasingly large number of patients undergoing total shoulder replacement combined with increased requirements for public reporting of patient outcomes, there is a greater need to better understand the underlying factors related to patient satisfaction. The purpose of this study was to compare patient demographics, non-orthopedic comorbidities, patient-reported outcome scores, and range of motion of patients who reported being either satisfied or dissatisfied following total shoulder replacement surgery at midterm follow-up.


Methods: We identified 234 primary total shoulder replacement surgeries performed by a single surgeon for shoulder arthritis with a minimum 2-year follow-up in a prospective shoulder arthroplasty registry. American Shoulder and Elbow Surgeons (ASES) score, patient satisfaction, and active forward flexion, abduction, and external

rotation at 0° of flexion-abduction were assessed before and after total shoulder replacement.


Results: Of the 234 patients, 207 (88.5%) were satisfied with their procedure. Dissatisfied patients had significantly lower ASES scores both before and after surgery (P < .001) as well as a significantly lower preoperative to postoperative change in ASES score (P < .001). Similarly, dissatisfied patients demonstrated significantly lower changes in active forward flexion (P = .004), abduction (P = .02), and external rotation (P = .03). Patients with ASES score changes <12 points were 19 times more likely to be dissatisfied after total shoulder replacement (95% confidence interval, 4.4-81.4; P = .0001).


Conclusion: Dissatisfied patients had significantly lower improvements in pain, function, and range of motion. Furthermore, a change in ASES score <12 points was associated with a 19-fold increase in the risk of being dissatisfied after total shoulder replacement.


Overall, excellent patient satisfaction rates were noted following total shoulder replacement for shoulder arthritis.


About Dr. Brent J. Morris Shoulder Replacement Specialist:

Dr. Brent J. Morris is a board-certified orthopedic surgeon and fellowship-trained shoulder and elbow specialist in Houston, Texas at Fondren Orthopedic Group, Texas Orthopedic Hospital.   Dr. Morris is a member of the American Academy of Orthopedic Surgeons (AAOS) and an Associate Member of American Shoulder and Elbow Surgeons (ASES). Dr. Morris and his research team have published extensively on total shoulder replacement surgery and ways to improve outcomes and patient satisfaction following shoulder surgery. He is co-author of a textbook devoted to total shoulder, reverse total shoulder replacement surgery, and revision shoulder replacement surgery, Shoulder Arthroplasty, 2nd Edition. For more information about Dr. Morris, visit online at


Brent J. Morris, MD

Orthopedic Surgery - Shoulder and Elbow Surgeon

Shoulder Replacement Specialist

TERFSES Shoulder and Elbow Fellowship Co-Director

Fondren Orthopedic Group

Texas Orthopedic Hospital

Houston, Texas



Jacobs CA, Morris BJ, Sciascia AD, Edwards TB. Comparison of Satisfied and Dissatisfied Patients 2 to 5 Years After Anatomic Total Shoulder Arthroplasty. Journal of Shoulder and Elbow Surgery. 2016;25:1128-1132.

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