Impact of Total Shoulder Arthroplasty on Generic and Shoulder-Specific Health-Related Quality-of-Life Measures A Systematic Literature Review and Meta-Analysis

Background: Total shoulder arthroplasty is increasingly used in the treatment of arthritis. However, the effect of total shoulder arthroplasty on health-related quality of life has not been fully established. The goal of this systematic review and meta-analysis was to characterize the change in generic and shoulder-specific health-related quality-of-life measures resulting from total shoulder arthroplasty. Methods: We identified published studies reporting preoperative and postoperative health-related quality-of-life out-comes for patients receiving total shoulder arthroplasty. Health-related quality-of-life measures were identified, and meta-analysis was used to calculate standardized mean differences (SMDs, reflective of the effect size) and 95 % confidence intervals for each scale. Results: Twenty studies (1576 total shoulder replacements) met the inclusion criteria. Outcome measures were ana-lyzed after an average postoperative follow-up duration of 3.7 ± 2.2 years. The Short Form-36 demonstrated significant improvement in physical component summary scores (SMD = 0.7, p < 0.001) but not in mental component summary scores (SMD = 0.2, p = 0.37). Significant improvements were observed in the visual analog scale score for pain (SMD = 22.5, p < 0.001) and scores on three shoulder-specific measures: the Constant score (SMD = 2.7, p < 0.001), American Shoulder and Elbow Surgeons score (SMD = 2.9, p < 0.001), and Simple Shoulder Test (SMD = 2.3, p < 0.001). Conclusions: Total shoulder arthroplasty leads to significant improvements in scores for function and pain. Shoulder