Toileting ability of patients after primary reverse total shoulder arthroplasty

Jorge Rojas, MD, MSc; Alexander Bitzer, MD; Jacob Joseph, BA; Uma Srikumaran, MD; Edward G. McFarland, MD

JSES International (Mar 2020)

Toileting ability of patients after primary reverse total shoulder arthroplasty

Jorge Rojas, MD, MSc,
Alexander Bitzer, MD,
Jacob Joseph, BA,
Uma Srikumaran, MD,
Edward G. McFarland, MD

Affiliations

Jorge Rojas, MD, MSc: Division of Shoulder Surgery, Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA
Alexander Bitzer, MD: Division of Shoulder Surgery, Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA
Jacob Joseph, BA: Division of Shoulder Surgery, Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA
Uma Srikumaran, MD: Division of Shoulder Surgery, Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA
Edward G. McFarland, MD: Corresponding author: Edward G. McFarland, MD, Department of Orthopaedic Surgery, Johns Hopkins University, 10753 Falls Rd, Ste 215, Lutherville, MD 21093, USA.; Division of Shoulder Surgery, Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA

Journal volume & issue: Vol. 4, no. 1
pp. 174 – 181

Abstract

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Background: This study aimed to determine the toileting ability (TA) of patients undergoing primary reverse total shoulder arthroplasty (RTSA) and identify factors associated with TA postoperatively. Methods: A questionnaire regarding toileting was administered to 119 patients who underwent primary RTSA with a minimum 1-year follow-up. Patients were separated into 2 groups based on whether the arm that underwent RTSA was the one used for toileting (study group, n = 74) or not (control group, n = 45). Patient-reported TA was calculated both before and after RTSA. Multivariate analysis was performed to identify factors associated with TA postoperatively. Results: Impairment in TA before RTSA was higher in the study group and affected almost three-quarters of the patients (72%). In the study group, primary RTSA resulted in a statistically significant improvement in TA (P < .001), and no difference in TA was found between groups after RTSA (P = .076). Postoperatively, 92% of the patients in the study group were able to manage toileting with the involved extremity (54% without difficulty and 38% with some degree of difficulty). Only 1 patient (1.3%) was totally unable to manage toileting with either arm postoperatively. The patients at risk of toileting difficulties postoperatively were those who had preoperative toileting difficulties and lower postoperative internal rotation range of motion. Conclusions: Over 90% of patients can manage toileting after primary RTSA, and total toileting inability is rare after the procedure (1.3%). Patients should be counseled that after primary RTSA, they have a high probability of being able to manage toileting with independence even if it is with some difficulty.

Published in JSES International

ISSN: 2666-6383 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery; Medicine: Internal medicine: Specialties of internal medicine: Diseases of the musculoskeletal system
Website: https://www.journals.elsevier.com/jses-international

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