title: Patients' expectations of shoulder instability repair.
abstract: OBJECTIVE
  To analyze and compare patient expectations of primary and revision shoulder stabilization and to assess the factors associated with patients' expectations.
  
  
  METHODS
  Pre-operative patient expectations after shoulder instability repair were prospectively assessed using a self-designed questionnaire. The survey included questions on the expected level and type of return to sports, instability, pain, risk of osteoarthritis, and overall shoulder condition.
  
  
  RESULTS
  One-hundred and forty-five patients (99 primary; 46 revision repair) were included. A return to sport at the same level with slight to no restrictions was expected in 95%, a return to high-risk activities in 34%, to moderate in 58%, and to low-risk activities in 9%. No pain [instability] independent of the activity level was expected by 71% [79%] and occasional pain [instability] during contact and overhead activities by 25% [19%]. 61% expected to have no risk of glenohumeral osteoarthritis, 37% a slight, and 2% a significant risk. The overall expectation for the post-operative shoulder was indicated to be normal or nearly normal in 99% of patients. The revision group did not differ from the primary repair group in any variable. High pre-operative sport performance was positively correlated with post-operative sport expectations. The number of dislocations, the duration of instability, and the subjective instability level were negatively correlated with return to sport expectations.
  
  
  CONCLUSIONS
  Patient expectations for primary and revision shoulder instability repair are high. Realistic patient expectations regarding the surgical procedure are necessary to avoid low patient satisfaction, especially in pre-operatively highly active and demanding athletes. The surgeon must not solely base the treatment on the pathology and possible risk factors for failure but should also take the individual expectation of the patient into account.
  
  
  METHODS
  III.
authors.affiliation: Department for Orthopedic Sports Medicine, Technical University Munich, Munich, Germany.|Department of Trauma, Hand and Reconstructive Surgery, Zentralklinikum Augsburg, Augsburg, Germany.
authors.forename: Johannes E
authors.initials: JE
authors.lastname: Plath
authors.affiliation: Department for Orthopedic Sports Medicine, Technical University Munich, Munich, Germany.|Department of Trauma and Orthopaedic Surgery, Trauma Center Murnau, Murnau, Germany.
authors.forename: Tim
authors.initials: T
authors.lastname: Saier
authors.affiliation: Department for Orthopedic Sports Medicine, Technical University Munich, Munich, Germany.|Department of Orthopedic Surgery and Traumatology, Freiburg University Hospital, Freiburg, Germany.
authors.forename: Matthias J
authors.initials: MJ
authors.lastname: Feucht
authors.affiliation: Department for Orthopedic Sports Medicine, Technical University Munich, Munich, Germany.|Department of Orthopedic Sports Medicine, Clinic Dr. Rinecker, Munich, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Minzlaff
authors.affiliation: Department for Orthopedic Sports Medicine, Technical University Munich, Munich, Germany.|Department of Trauma and Orthopedic Surgery, Clinic Barmherzige Brüder, Munich, Germany.
authors.forename: Gernot
authors.initials: G
authors.lastname: Seppel
authors.affiliation: Department for Orthopedic Sports Medicine, Technical University Munich, Munich, Germany.
authors.forename: Sepp
authors.initials: S
authors.lastname: Braun
authors.affiliation: Center of Orthopedics and Rehabilitation Excellence (CORE), West Jordan, UT, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Hatch
authors.affiliation: Department for Orthopedic Sports Medicine, Technical University Munich, Munich, Germany. A.Imhoff@lrz.tu-muenchen.de.
authors.forename: Andreas B
authors.initials: AB
authors.lastname: Imhoff
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000523:psychology / Q000534:rehabilitation / Q000601:surgery; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000523:psychology* / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000517:prevention & control / Q000523:psychology; D017060:Patient Satisfaction; D020127:Recovery of Function; D012086:Reoperation; D000068958:Return to Sport / Q000523:psychology*; D012307:Risk Factors; D000070636:Rotator Cuff Injuries / Q000523:psychology / Q000534:rehabilitation / Q000601:surgery; D012783:Shoulder Dislocation / Q000523:psychology / Q000534:rehabilitation / Q000601:surgery; D000070599:Shoulder Injuries / Q000523:psychology* / Q000534:rehabilitation / Q000601:surgery; D012785:Shoulder Joint / Q000601:surgery*; D011795:Surveys and Questionnaires; D055815:Young Adult