背景:肩袖病变是一种常见的肩关节病变,主要影响年龄>50岁的患者。这种情况不仅伴随着疼痛和功能丧失,而且伴随着生活质量和心理压力的损害。经常采用的治疗选择是关节镜修复。但是,患者和外科医生对手术后结果的期望可能会有所不同,因此会导致双方的不满。这项研究的目的是记录患者对计划的关节镜肩袖修复的期望,并将结果与肩关节外科医生的评估进行比较。
方法:共有303名患者和25名外科医生参与了这项研究。这项研究包括计划进行关节镜修复的肩袖部分或全层撕裂的患者。术前,他们被要求填写调查问卷,询问社会人口统计数据,基础病理的分数,以及对手术缓解疼痛的期望,运动范围和力量的增益,以及对日常生活活动的影响,工作,和体育。此外,对25位外科医生进行了调查,了解他们认为他们的患者使用相同的标准化问题的期望。
结果:在患者中,43.9%的人认为增加活动范围是肩袖修复后最重要的目标,其次是疼痛缓解(30.6%)和力量增加(13.7%)。在外科医生中,72%的人认为疼痛缓解对患者最重要,其次是运动(20%)和力量(8%)。当被问及手术后哪个参数最重要时,对于患者来说,运动排在第一位,疼痛第二,力量第三。对于肩部专家来说,排名是痛苦,运动,和力量。与患者相比,外科医生在运动排名时明显高估了疼痛缓解。
结论:患者对手术的期望与外科医生的评估不同。虽然增加运动范围对患者更重要,外科医生显然投票赞成缓解疼痛。因此,应在治疗前访谈中讨论不同的期望,并在计划正确的治疗时予以考虑。这可能会使双方更加满意。
BACKGROUND: Rotator cuff lesions are a common shoulder pathology mainly affecting patients aged >50 years. This condition is accompanied by not only pain and loss of function but also impaired quality of life and psychological stress. A frequently employed treatment option is arthroscopic repair. But expectations regarding the outcome after surgery might differ between patients and surgeons and therefore lead to dissatisfaction on both sides. The aim of this study was to document patient expectations of a planned arthroscopic rotator cuff repair and compare the results with the assessment of shoulder surgeons.
METHODS: A total of 303 patients and 25 surgeons were involved in this study. Patients with partial- or full-thickness tear of the rotator cuff scheduled for arthroscopic repair were included in this study. Preoperatively, they were asked to fill out questionnaires inquiring sociodemographic data, scores of the underlying pathology, as well as expectations regarding the operation with regard to pain relief, gain of range of motion and strength, as well as the effect on activities of daily life, work, and sports. Furthermore, 25 surgeons were surveyed on what they think their patients expected using the same standardized questions.
RESULTS: Among the patients, 43.9% considered gain of range of motion to be the most important goal after rotator cuff repair, followed by pain relief (30.6%) and gain of force (13.7%). Among the surgeons, 72% believed pain relief to be the most important for their patient followed by movement (20%) and strength (8%). When asked which parameter was the most important to achieve after operation, for patients, movement was on first place, pain second, and strength third. For shoulder specialists, the ranking was pain, movement, and strength. Surgeons significantly overrated pain relief when ranking against movement compared with their patients.
CONCLUSIONS: The expectations of patients regarding their operation differ from the surgeon\'s assessment. Whereas gaining range of motion was more important for patients, surgeons clearly voted for pain relief. Different expectations should therefore be discussed within the pretreatment interview and taken into account when planning the right therapy. This might lead to better satisfaction on both sides.