I just came back from my preop counseling visit with the nurse. I’m going to have a shoulder replacement in three days. One of the handouts she gave me lists all the things that could be counted as reasons for a surgical failure. One of them was patient dissatisfaction. Why are people dissatisfied after this surgery? The handout didn’t really say.

Any time someone faces surgery for any reason, it is necessary to disclose any and all potential problems that could occur. The list can be very long and seem impersonal. You might even think, Oh, that will never happen to me!. It can include minor problems like fever to major problems like infection.

Any surgery puts a person at risk of problems and complications — even death. Post-operative problems are more likely to develop if there are other health problems (e.g., heart disease, diabetes) that can increase the risk of serious complications with any surgery. Thankfully, serious risks and the risk of death are fairly low for a shoulder joint replacement surgery.

Patient dissatisfaction is counted as a measure of success. The surgeon could do a beautiful job installing the implant, but if you aren’t happy with the results, then the surgery wasn’t really a success, now was it? Patients report being dissatisfied when their pre- and postoperative pain levels are no different. In fact, pain could be higher after surgery. Motion and function are usually adversely affected by pain, so there are even more reasons to be unhappy.

But it’s also a fact that sometimes patients go into surgery with unreasonable expectations. They may think the new implant will allow them to do things they haven’t done in 50 years! That can create some dynamic tension and dissatisfaction. A high activity level can increase the risk of problems like implant loosening or debris collecting inside the implant just from wear and tear. That doesn’t usually happen at first but it can contribute later to patient dissatisfaction with the long-term results.

So you can see, there are a multitude of reasons why patient satisfaction may come up short after shoulder replacement surgery. But most people find that with a little patience and careful attention to their rehab program, they do just fine and are quite happy with the results.