Patient Understanding, Expectations, and Satisfaction Regarding Rotator Cuff Injuries and Surgical Management

Rotator cuff injuries are among the most common in orthopaedics, with rotator cuff repair surgery consistently reported as one of the most commonly performed orthopaedic procedures. Patient satisfaction is becoming an increasingly important outcome metric as health care continues to evolve with regard to quality measures affecting physician reimbursement. Evidence supports that postoperative patient satisfaction, an important quality outcome metric, is highly influenced by preoperative patient expectations, which are in turn governed by patient knowledge and understanding. Many authors have delineated patient-, injury-, and surgery- specific variables associated with high preoperative expectations and satisfaction after rotator cuff surgery. Specifically, large rotator cuff tears, subscapularis tears, persistence of postoperative pain and dysfunction, worker's compensation cases, lower education level, and preoperative disability have been seen more frequently in patients reporting poor satisfaction. Others have reported variables associated with higher patient satisfaction such as being married, employed, and of older age at the time of surgery (> 55 years old) predictive of higher satisfaction. Patient education preoperatively regarding details about the surgery and the postoperative plan both immediately after the procedure and for rehabilitation are critical in helping set patients' preoperative expectations that have a known effect on patients' subjective clinical outcomes.