JSES - 2026-09-21 - Journal Article
Early Postoperative Predictors of Two-Year Satisfaction after Ream and Run Arthroplasty.
Levins JG, Yamaguchi JT, Whitson AJ, Matsen FA, Schiffman CJ, Hsu JE
Topics
Key Takeaway
A positive SST-1 response (comfortable at rest) at 3 months post-ream-and-run confers 15.7 times increased odds of 2-year satisfaction, and a positive SST-2 response (comfortable sleeping) at 6 months confers 6.2 times increased odds.
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Summary
This study asked whether early postoperative pain at rest (SST-1) and with sleep (SST-2) at 3 and 6 months predict 2-year satisfaction after ream-and-run arthroplasty in 375 patients from a longitudinal database. PPV for SST-1 exceeded 80% at all time points; a positive SST-1 at 3 months yielded OR 15.7 (95% CI 4.09–60.41) for satisfaction on multivariate analysis. Male sex and nondiabetic status were additional independent predictors of satisfaction.
Key Limitation
Satisfaction was assessed as a binary outcome at a single 24-month time point, which does not capture patients who became satisfied after initial dissatisfaction or vice versa during the known prolonged recovery curve of ream-and-run.
Original Abstract
BACKGROUND
Treatment of glenohumeral arthritis in the young, active patient is challenging. The ream-and-run (RnR) arthroplasty allows for unrestricted activity but in some patients can include difficult and longer post-operative rehabilitation and a higher early revision rate. Improvement can occur up to 2 years after surgery, but counseling on expectations in the early postoperative period is uncertain. The objective of this study was to determine if shoulder pain at rest and with sleep in the early post-operative period were predictive of satisfaction at 2 years post-operatively.
METHODS
This study included 375 patients from a longitudinally maintained shoulder arthroplasty database who underwent RnR with minimum 2-year follow-up. Preoperative Simple Shoulder Test (SST) scores, baseline characteristics, and postoperative SST scores were collected at regular intervals. Satisfaction was assessed at 24 months. We specifically examined responses to the SST Questions 1 (SST-1) and 2 (SST-2): "is your shoulder comfortable at rest?" and "does your shoulder allow you to sleep comfortably at night?" at 3 and 6 months postoperative in patients who were or were not satisfied at 24 months. Positive and negative predictive values (PPV and NPV) were calculated. A multivariate binomial logistic regression was performed to control for age, sex, prior surgery, and baseline SST to determine whether patient responses of SST-1 and SST-2 at 3 and 6 months were associated with 2-year satisfaction.
RESULTS
Male sex (satisfied 96.6% vs. dissatisfied 84.5%, p<0.018) and nondiabetic status (satisfied diabetics 2.1% vs dissatisfied diabetics 8.3%, p=0.036) were patient factors associated with 2-year satisfaction. The PPV of SST-1 was nearly 80% at every time point, and the NPV of SST-1 reached 80% at 3 months and 1 year. The PPV of SST-2 was greater than 80% at every postoperative time point, while the NPV rose to 50.6% at 6 months and 63.6% at 12 months. From the multivariable analysis at 3 months, a positive response to SST-1 was associated with a 15.7 times increased odds of 2-year satisfaction (95% CI 4.09-60.41, p<0.001). At 6 months, a positive response to SST-2 was associated with a 6.2 times increased odds of satisfaction (95% CI 3.42-11.06, p<0.001).
CONCLUSIONS
Shoulder comfort at rest at 3 months and shoulder comfort during sleep at 6 months are independent predictors of 2-year satisfaction after RnR. These data can be considered in determining prognosis for patients in the early recovery after ream and run arthroplasty.
LEVEL OF EVIDENCE
Level IV, Case Series, Prognosis Study.