Patient self-selection does not influence postoperative improvements in pain, function, or satisfaction in ream-and-run arthroplasty patients.

Background: The ream-and-run arthroplasty (RnR) has shown to be a viable treatment option for young, active patients with shoulder osteoarthritis. However, there are notable concerns with the generalizability of these findings as much of the literature on the RnR is published by the originating surgeon. Additionally, a high proportion of RnR patients represented in the studies are self-selecting the procedure, which may introduce biased outcomes. Therefore, our purpose was to compare the clinical outcome improvement and satisfaction of patients who self-selected the RnR procedure as their preferred treatment method and those who did not.

Methods: We used a retrospective, cross-sectional comparative study design and included patients that had undergone a RnR performed by one fellowship-trained orthopedic surgeon with a minimum of 1-year follow-up. Patients who deliberately sought out the surgeon and RnR procedure made up the self-selecting group (RnR_SS), and all other patients who underwent the RnR procedure and met inclusionary criteria were our control group (RnR_CON). Clinical improvement at the most recent follow-up visit on the Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons (ASES), daily and worst pain outcomes, were compared between groups. Satisfaction at their latest follow-up post-arthroplasty was also compared.

Results: A total of 78 shoulders (47=RnR_SS, 31=RnR_CON) belonging to 70 patients were included. Both groups reported significant improvements at the latest follow-up compared to their preoperative condition (P < .001), and no differences were found between groups in MOI% (P > .05) or proportion of patients reaching minimal clinically important difference (MCID) on any patient-reported outcome. Groups also reported similar subjective satisfaction ratings (P > .05).

Conclusions: RnR patients self-selecting the RnR arthroplasty were found to report similar pain and functional improvements, and satisfaction ratings as those who were not specifically seeking out the procedure. This finding provides evidence to support generalizability of previous RnR results as patients self-selecting the RnR likely make up a bulk of those represented in existing literature.