Gender differences in expectations and outcomes for total shoulder arthroplasty: a prospective cohort study.
BACKGROUND
Gender has an impact on the expectations and the outcomes of orthopedic procedures. The data examining the effect of gender on total shoulder arthroplasty (TSA) are limited but suggest that women may have worse outcomes. We performed a prospective comparison between men and women with regard to expectations and midterm functional outcomes for TSA.


METHODS
The study prospectively enrolled 63 patients receiving a TSA with a minimum of 3 years of follow-up. The cohort included 36 men and 27 women with a mean age of 60.8 years for men (range, 37-79 years) and 66.4 years (P = .01) for women (range, 52-77 years.) Each patient was given a preoperative survey in which patients were asked to select 3 expectations they most hoped to gain from surgery. Functional outcomes were measured with American Shoulder and Elbow Surgeons and 12-Item Short Form Health Survey scores.


RESULTS
There were differences in expectations between the genders. Men chose exercise or participation in sports (24/36) whereas women chose to maintain daily routine and chores (18/27) (P < .01) as their top expectation. Both, however, chose to sleep through the night similarly as the next most important expectation. Each achieved their expectations at similar and high rates. American Shoulder and Elbow Surgeons and 12-Item Short Form Health Survey scores, respectively, increased significantly but did not differ between genders.


CONCLUSIONS
TSA results in excellent improvement of functional outcomes for both men and women without a significant difference at midterm follow-up. Men, on average, are younger and value participation in sports. Women hope to improve their ability to do their daily routine and chores. Both value sleeping through the night.
Tufts University Medical School, Boston, MA, USA; The New England Baptist Hospital, Boston, MA, USA; Boston Sports and Shoulder Center, Chestnut Hill, MA, USA. Electronic address: andrewjawa@gmail.com.
Andrew
A
Jawa
The New England Baptist Hospital, Boston, MA, USA.
Umer
U
Dasti
Beth Israel Deaconess Hospital, Boston, MA, USA.
Amy
A
Brown
Beth Israel Deaconess Hospital, Boston, MA, USA.
Kathryn
K
Grannatt
The New England Baptist Hospital, Boston, MA, USA; Boston Sports and Shoulder Center, Chestnut Hill, MA, USA.
Suzanne
S
Miller
D000328:Adult; D000368:Aged; D000072228:Arthroplasty, Replacement, Shoulder; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012737:Sex Factors; D012785:Shoulder Joint; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
Gender; age; expectations; functional outcomes; men; shoulder arthroplasty; women