Journal of shoulder and elbow surgery
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Patients' preoperative expectations of shoulder surgery affect both the decision to proceed with surgery and how patients assess outcomes of surgery. Our goals were to identify patients' expectations of shoulder surgery, to develop and test a patient-derived shoulder surgery expectations survey, and to determine the prevalence of major expectations by diagnosis. An initial sample of 409 patients (mean age, 51 +/- 17 years; 58% men) with diverse shoulder diagnoses were asked open-ended questions preoperatively about their expectations of shoulder surgery. ⋯ Items retained to form the final survey were frequently cited, represented clinically relevant or potentially unrealistic expectations, and had concordance levels of 0.40 to 0.83 measured by the kappa statistic (71% had kappa >or= 0.60). The final 17-item Hospital for Special Surgery Shoulder Surgery Expectations Survey requires less than 5 minutes to complete. This patient-derived, self-administered survey has several possible uses in daily clinical practice, such as providing a way to learn about the patient's perspectives, providing the orthopaedist with a template to guide a formal discussion about realistic and unrealistic goals, and providing a prospective record that can be used jointly by the orthopaedist and patient postoperatively to assess the outcome of surgery.