ArticleJSES international2026
Complete fulfillment of expectations is associated with greater satisfaction after shoulder arthroplasty: results from a prospective multicenter cohort study.
Article in JSES international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
Background: With this study, we aim to explore pre-operative probabilistic expectations (what does the patient realistically expect) and value-based expectations (what does a patient consider important), post-operative expectation fulfillment, and the relationship with post-operative satisfaction in shoulder arthroplasty (SA) patients. We hypothesized that higher expectation fulfillment is related to higher post-operative satisfaction, corrected for baseline level of optimism. Methods: In this prospective multicenter cohort study, 230 SA patients were included. These patients completed pre-operative questionnaires measuring probabilistic (Sunnybrook questionnaire) and value-based expectations (Hospital for Special Surgery Shoulder Expectations questionnaire) as well as optimism (Life Orientation Test - Revised). Post-operatively, expectation fulfillment/improvement and post-operative satisfaction were measured. We used ordinal logistic regression to study whether expectation fulfillment is related to post-operative satisfaction, corrected for baseline level of optimism. Results: For pre-operative probabilistic expectations, patients expected improvement on a median of 5 domains (interquartile range 4-6) out of 6 possible domains. For pre-operative value-based expectations, patients had a median of 5 (interquartile range 3-9) out of 17 possible expectations that they valued as 'Very important'. At 6 months and 12 months, the median percentage of completely fulfilled probabilistic expectations per patient was 75% and 80%, respectively. The median percentage of completely improved 'very important' value-based expectations per patient was 7.7% and 14.3%. Patients with higher percentages of fulfilled or improved expectations had higher odds of being 'very satisfied' post-operatively. Conclusion: This study shows that fulfillment of probabilistic expectations and improvement on value-based expectations is associated with post-operative satisfaction after SA.
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