Obana Kyle K, Lind Dane R G, Luzzi Andrew J, O'Connor Michaela J, LeVasseur Matthew R, Levine William N
Department of Orthopaedic Surgery, New York-Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA.
Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO, USA.
JSES Rev Rep Tech. 2024 Oct 19;5(1):7-13. doi: 10.1016/j.xrrt.2024.09.005. eCollection 2025 Feb.
Reverse total shoulder arthroplasty (rTSA) demonstrates favorable long-term data and has outpaced anatomic total shoulder arthroplasty and hemiarthroplasty as the most-performed shoulder arthroplasty procedure. As indications and outcomes continue to favor rTSA, patients may turn to the internet as an efficient modality to answer various questions or concerns. This study investigates online patient questions pertaining to rTSA and the quality of the websites providing information.
(1) Questions will pertain to surgical indications, timeline of recovery, and postoperative restrictions; (2) the quality and transparency of online information is largely heterogenous.
Three rTSA searches were entered into the Google Web Search. Questions under the "People also ask" tab were expanded sequentially and 100 consecutive results for each query were included for analysis (300 in total). Questions were categorized based on Rothwell's Classification and subcategorized by topic. Websites were categorized by source. Website quality was evaluated by the Journal of the American Medical Association (JAMA) Benchmark Criteria.
Most questions fell into the Rothwell Fact category (49.7%). The most common question topics were Timeline of Recovery (17.3%), Specific Activities (14.7%), and Restrictions (11.3%). The least common question topics were Anatomy/Function (0.0%), Cost (0.3%), and Diagnoses/Evaluation (0.3%). The most common websites were Medical Practice (45.0%), Academic (22.3%), and Single Surgeon (12.3%). PubMed articles consisted of 41.2% of Government websites. The average JAMA score for all websites was 1.48 ± 1.27. Government websites had the highest JAMA score (3.11 ± 1.01) and constituted 55.9% of all websites with a score of 4/4. Medical Practice websites had the lowest JAMA score (0.99 ± 0.91).
Patients are interested in the timeline of recovery, ability to perform specific activities after surgery, and short-term and long-term restrictions following rTSA. Although all patients will benefit from education on ways to perform activities of daily living while abiding by postoperative restrictions, physicians should set preoperative expectations regarding return-to-activity following rTSA in younger, more active patients. Finally, surgeons should provide patients with physical booklets and online information available on their websites to avoid reliance on low-quality online sources.
反向全肩关节置换术（rTSA）显示出良好的长期数据，并且作为最常施行的肩关节置换手术，其发展速度已超过解剖型全肩关节置换术和半肩关节置换术。随着适应症和治疗效果持续支持rTSA，患者可能会转向互联网，将其作为一种高效的方式来解答各种疑问或担忧。本研究调查了与rTSA相关的在线患者问题以及提供信息的网站质量。
（1）问题将涉及手术适应症、恢复时间线和术后限制；（2）在线信息的质量和透明度在很大程度上存在异质性。
在谷歌网络搜索中输入三次rTSA搜索。依次展开“人们也问”标签下的问题，并纳入每个查询的100个连续结果进行分析（共300个）。问题根据罗斯韦尔分类法进行分类，并按主题进行子分类。网站按来源进行分类。网站质量由美国医学会（JAMA）基准标准进行评估。
大多数问题属于罗斯韦尔事实类别（49.7%）。最常见的问题主题是恢复时间线（17.3%）、特定活动（14.7%）和限制（11.3%）。最不常见的问题主题是解剖学/功能（0.0%）、费用（0.3%）和诊断/评估（0.3%）。最常见的网站类型是医疗实践网站（45.0%）、学术网站（22.3%）和单医生网站（12.3%）。政府网站中的PubMed文章占41.2%。所有网站的平均JAMA评分为1.48±1.27。政府网站的JAMA评分最高（3.11±1.01），在所有得分为4/4的网站中占55.9%。医疗实践网站的JAMA评分最低（0.99±0.91）。
患者对rTSA后的恢复时间线、术后进行特定活动的能力以及短期和长期限制感兴趣。虽然所有患者都将从关于在遵守术后限制的同时进行日常生活活动的方法的教育中受益，但医生应该对年轻、活动量较大的患者在rTSA后的恢复活动设定术前预期。最后，外科医生应该为患者提供实体手册以及其网站上的在线信息，以避免患者依赖低质量的在线资源。
