Effects of pre-operative patient expectations on the outcome after total shoulder arthroplasty: A systematic review

Aim To synthesize the evidence considering effects of pre-operative patient expectations on the post-operative outcomes in patients with total shoulder arthroplasty.Methods PubMed, Web of Science and Cochrane were searched for relevant studies. Studies before 2000 were excluded. Studies examining effects of pre-operative patient expectations on post-operative outcome in adults who had undergone total shoulder arthroplasty were included if at least one of the following treatment outcomes should have been measured: shoulder function, range of motion, shoulder pain, activities of daily living, muscle strength, patient satisfaction, or quality of life. After screening 875 studies four studies were included. Relevant data was extracted in a standardized way. Quality assessment was performed through QUIPS and EBRO methods. Both were performed by two independent reviewers.Results All 4 studies had a high risk of bias and level of evidence B. Moderate evidence was found regarding the absence of an association between greater pre-operative patient expectations and numerous outcome measures. All other associations yielded conflicting or preliminary evidence.Discussion Informing patients about what can be expected can be of great importance. Evidence lacking. To confirm or reject the findings of this systematic review, future research should focus on high-quality research with validated research protocols.