Factors Predicting Postoperative Range of Motion and Muscle Strength one Year after Shoulder Arthroplasty

Background: Shoulder arthroplasty improves shoulder range of motion (ROM), strength and function in patientswith advanced shoulder disease. However, clinical outcomes vary and are not always predictable among patients.Pre-operative factors and patients’ characteristics may influence improvement after surgery. This study examined theimpact of the pre-operative objective measures range of motion (ROM) and strength, age, sex, and comorbidities onshoulder ROM, strength status and the amount of improvement one year following shoulder arthroplasty.Methods: ۱۴۰ patients were assessed pre-operatively and one year after shoulder arthroplasty in this prospectivecohort study. Pearson’s correlations and multiple regression analyses were performed to test the impact of potentialpredictors on abduction, flexion, internal rotation and external rotation ROM as well as on shoulder abductors, flexors,internal rotators and external rotators strength at one year.Results: Pre-operative ROM significantly predicted ۱۰% - ۳۷% of the improvement in ROM after surgery. Less preoperativeROM was associated with a greater improvement in ROM. Less pre-operative muscle strength was associatedwith a greater improvement in strength after surgery. Pre-operative shoulder muscles predicted ۲۸% - ۳۸% of thestrength status at one year, and ۲۴% - ۴۳% of the improvement in strength postoperatively. Older age was associatedwith less improvement in ROM and strength at one year. With other predictors, age explained ۳۷% of the change inROM and ۳۶% of the change in strength. Male sex was associated with greater improvement in muscle strength. Sexsignificantly predicted ۲۴% - ۳۶% of the change in strength.Conclusion: Pre-operative ROM and strength, age, and sex are significant predictors of the improvement in theshoulder ROM and strength one year after shoulder arthroplasty. The improvement in these measures is expected todecline with age and men are expected to gain more strength than women following this surgical intervention.Level of evidence: II

Keywords:

Muscle strength , Range of motion , Shoulder Arthroplasty