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What’s the value of total shoulder arthritis? How can it be improved upon?


A procedure’s value to patients can be described as its quality and cost. The quality of care includes improvements in patient satisfaction and the resolution of intra- or post-operative complications.

The authors of Measuring Patient Value after Total Shoulder Arthroplasty sought calculate the patient value delivered by total shoulder arthroplasty (TSA) for 116 consecutive TSAs.

Value for patients was defined as the ratio of quality of care to direct surgical costs; preoperative costs (i.e. Imaging, planning and postoperative costs (i.e. physical therapy) were not considered. Physical therapy was not included in the assessment.

Compared to a reference threshold of 1.0, ninety patients (78%) had a quality of care ≥1.0 and 61 patients (53%) had direct costs related to surgery ≤1.0. 

The average value delivered to patients was higher for non-smokers, for those receiving anatomic TSA (as opposed to reverse TSA),  those with higher pre-operative pain, and lower pre-operative function.

43% of patients were found below the rectangle with the highest value (green), while 13% were below the rectangle with the lowest value.

19% of patients suffered from intra- or post-operative complications. 


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