title: Patient expectations before arthroscopic shoulder surgery: correlation with patients' reasons for seeking treatment.
abstract: BACKGROUND
  Elevated expectations before orthopaedic procedures appear to correlate with inferior preoperative subjective measures. The purpose of this study was to evaluate preoperative patient expectations before arthroscopic shoulder surgery and to correlate them with preoperative subjective measures and patients' reasons for seeking treatment.
  
  
  METHODS
  We prospectively collected and retrospectively analyzed data from patients before elective arthroscopic shoulder surgery for a wide range of pathologic processes. Preoperative subjective data included QuickDASH scores, pain and functional components of the American Shoulder and Elbow Surgeons (ASES) score, and mental and physical components of the SF-12 score. Expectations data were collected and grouped on the basis of the reasons for seeking of medical treatment and ranked according to their relative importance.
  
  
  RESULTS
  The study included 313 shoulders. There were 205 men and 108 women with a mean age at surgery of 48.7 years (range, 18-78 years). Overall, the most important expectations were for the "shoulder to be back to the way it was before the problem started" and to continue participation in sporting activities. Patients who presented with the "shoulder coming out" had fewer important expectations than did those who presented for other reasons. Those patients who indicated a desire to continue participation in sports had significantly less pain (improved ASES pain scores) compared with the rest of the population.
  
  
  CONCLUSIONS
  Although return to sport was the most important expectation overall, the importance of other expectations varied by patients' reasons for seeking treatment. The current questionnaire may have limited use in patients with shoulder instability.
  
  
  METHODS
  Level III, cross-sectional design, epidemiology.
authors.affiliation: Steadman Philippon Research Institute, Vail, CO, USA.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Warth
authors.forename: Karen K
authors.initials: KK
authors.lastname: Briggs
authors.forename: Grant J
authors.initials: GJ
authors.lastname: Dornan
authors.forename: Marilee P
authors.initials: MP
authors.lastname: Horan
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Millett
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000523:psychology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D017060:Patient Satisfaction; D057234:Preoperative Period; D020127:Recovery of Function; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000601:surgery*; D013177:Sports; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cross-Sectional Design; Epidemiology; Level III; Shoulder; arthroscopy; expectations; outcomes; preoperative