Patients’ characteristics, rather than shoulders, are increasingly being recognized as the key factors that will determine the outcome of shoulder surgery. A recent article, “Comparision of total shoulder arthroplasty with reverse shoulder arthroplasty” outlined the difficulties of managing the shoulder in patients with inflammatory arthritis. It highlighted the high rate of cuff tears with anatomic arthroplasty, as well as the high rates for acromial or spine fractures following reverse total shoulder.
According to the authors of “Economic and educational disparities are associated a higher risk of revision surgery after shoulder arthroplasty”, they also considered other patient characteristics that can have an impact on the outcome of arthroplasty. These include poor education, poverty, social deprivation, and adverse environmental conditions. They compared revision rates for 5190 patients with these socio determinants of their health (SDOH), to 5190 matched individuals without.
The SDOH cohort was 89.2% economically disadvantaged. Next came social (14.3%) and environmental (8.0%), but it is clear that all or some of these can co-exist with a patient.
Comparable with…
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