Clinical outcome in patients with hand lesions associated with complex regional pain syndrome after arthroscopic rotator cuff repair

Abstract

Background: Complex regional pain syndrome (CRPS)-related hand lesions are one of the complications following arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the clinical outcomes of patients with CRPS-related hand lesions following ARCR.Methods: Altogether, 103 patients with ARCR were included in this study (mean age, 63.6±8.2 years; 66 males and 37 females; follow-up period, preoperative to 12 months postoperative). Clinical assessment included the Japanese Orthopaedic Association (JOA) score, University of California, Los Angeles (UCLA) score, Constant score, 36-item short form health survey (SF-36) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score from preoperative to 12 months postoperatively. The patients were either assigned to the CRPS group or non-CRPS group depending on CRPS diagnosis until the final follow-up, and clinical outcomes were then compared between the groups.Results: Of 103 patients, 20 (19.4%) had CRPS-related hand lesions that developed entirely within 2 months postoperatively. Both groups showed significant improvement in JOA, UCLA, and Constant scores preoperatively to 12 months postoperatively (P<0.0001). Comparisons between the two groups were not significantly different, except for SF-36 “general health perception” (P<0.05) at 12 months postoperatively. At final follow-up, three patients had residual CRPS-related hand lesions with limited range of motion and finger edema.Conclusions: CRPS-related hand lesions developed in 19.4% of patients following ARCR. Shoulder or upper-limb function improved in most cases at 12 months, with satisfactory SF-36 patient-based evaluation results. Patients with residual CRPS-related hand lesions at the last follow-up require long-term follow-up.

A novel high mechanical and excellent hydrophilic electrospun polyurethane‐silk‐bioactive glass nanofiber film for rotator cuff injury repair

“…At present, the most commonly used method to treat rotator cuff injury is arthroscopic rotator cuff repair 5 . However, some scholars believed the poor strength of the scar tissue formed by the traditional postoperative tendon‐osseointegration surface is an important reason for the failure of the repair owing to the special structure of the rotator cuff, which consists of four parts: tendons, uncalcified fibrocartilage, calcified fibrocartilage and bone tissue 6–8 . Traditional surgical methods for rotator cuff repair could not achieve satisfactory results, especially the incidence of rotator cuff tissue non‐union and rotator cuff re‐tear much high after the repair of large‐area rotator cuff injuries.…”

“…5 However, some scholars believed the poor strength of the scar tissue formed by the traditional postoperative tendon-osseointegration surface is an important reason for the failure of the repair owing to the special structure of the rotator cuff, which consists of four parts: tendons, uncalcified fibrocartilage, calcified fibrocartilage and bone tissue. [6][7][8] Traditional surgical methods for rotator cuff repair could not achieve satisfactory results, especially the incidence of rotator cuff tissue non-union and rotator cuff re-tear much high after the repair of large-area rotator cuff injuries. In recent years, domestic and foreign scholars have successively launched new explorations and proposed the use of stents to repair rotator cuff injuries, which is attracting widespread attention.…”