Increased complications and similar patient recorded outcomes after shoulder arthroplasty in patients with functional somatic syndromes.

Abstract

Background: The purpose of this study was to compare patient-reported outcomes measures, complication rates, and return to hospital in a cohort of patients undergoing anatomic total shoulder arthroplasty (aTSA) or reverse total shoulder arthroplasty (rTSA) with at least one functional somatic syndrome (FSS) to a control cohort.

Methods: A retrospective review identifying patients who underwent rTSA or aTSA from 2015 to 2022 was performed. Patients with one or more FSS diagnosis (irritable bowel syndrome, chronic headache, chronic low back pain, or fibromyalgia) were compared against a control cohort. Demographic data, comorbidities, operative data, and patient recorded outcomes including Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE), Pain Interference (PI), and Depression (D) were collected. A 1:1 propensity matching to control for age, gender, and body mass index was performed.

Results: A total of 54 patients in the FSS cohort and 125 control patients without FSS were included. The FSS cohort had significantly higher rates of depression (p < 0.001), anxiety (p < 0.001), and postoperative complications (35.2% vs. 14.4%, p = 0.002). No significant differences in change in PROMIS-UE, -PI, and -D scores or proportion meeting minimal clinically important difference were seen at one year among the propensity-matched cohort.

Discussion: Patients with FSS undergoing shoulder arthroplasty had higher rates of complications; however, PROMIS scores were similar between cohorts.

Level of evidence: Level III.