Early detection and treatment of complications in the fingers and hand after arthroscopic rotator cuff repair

Abstract

Background Complications in the fingers and hand after arthroscopic rotator cuff repair (ARCR) have been reported to include carpal tunnel syndrome (CTS), flexor tenosynovitis (TS), and complex regional pain syndrome. These studies were conducted retrospectively; however, the reported complications have not been examined prospectively. The aim of this study was to evaluate the outcomes of early detection and treatment of the complications after ARCR. Methods Forty-six patients (48 shoulders) who underwent ARCR were prospectively examined to investigate complications in the fingers and hand after ARCR. We attempted to immediately detect and proactively treat these complications. We evaluated the outcomes of the early detection and treatment of the complications. Results Complications were observed in 17 hands (35%) and occurred an average of 1.5 months after ARCR. The symptoms in 3 hands resolved spontaneously, 2 hands were diagnosed with CTS, and 12 hands were diagnosed with TS. Of the 12 hands with TS, 11 exhibited no triggering of the fingers. Among the 14 hands diagnosed with CTS or TS, 13 hands (CTS: 2 hands, TS: 11 hands) were treated with corticosteroid injections; the mean interval between treatment initiation and symptom resolution was 1.0 months (0.5-3.0 months). None exhibited complex regional pain syndrome. Conclusions When symptoms occur in the fingers and hand after ARCR, CTS or TS should be primarily suspected. The diagnosis of TS must be made carefully because most patients with TS have no triggering. For patients with CTS or TS after ARCR, rapid corticosteroid injection administration can lead to improvement in these symptoms.

Risk factors related to complications of the fingers and hand after arthroscopic rotator cuff repair – carpal tunnel syndrome, flexor tenosynovitis, and complex regional pain syndrome

“…Among them, the diagnosis was CTS in 2 hands, TS in 15 hands, and both CTS and TS in 3 hands; none of the hands exhibited CRPS. In our retrospective 4 and prospective 5 studies, we also reported that the complications of the fingers and hand that occurred after ARCR were mainly CTS or TS and that none of the hands exhibited CRPS after ARCR. Our current and previous studies suggest that CTS or TS can easily occur after ARCR.…”

“…In our study, 20 patients (20 hands) (40%) had complications of the fingers and hand after ARCR, with a frequency higher than that reported in previous studies on CTS, TS, and CRPS, which ranged from 0% to 35% after ARCR. 1 , 4 , 5 , 14 , 18 , 23 This relatively high frequency might be because we included slight symptoms as complications. By including these symptoms, we were able to diagnose and treat them to prevent them from worsening.…”

“…In our retrospective 4 and prospective 5 studies about the complications of the fingers and hand that occur after ARCR, we observed cubital tunnel syndrome, carpal tunnel syndrome (CTS), and flexor tenosynovitis (TS), but no patients exhibited CRPS. However, no studies have investigated the factors related to complications of the fingers and hand after ARCR, including cubital tunnel syndrome, CTS, and TS.…”

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

“…Harada et al [ 26 , 27 ] reported that the most common complication with hand symptoms after ARCR is flexor tenosynovitis followed by carpal tunnel syndrome, and prompt treatment with corticosteroid injections is recommended. Thus, the possibility that hand lesions after ARCR may be influenced by other diseases presenting with CRPS-like symptoms is becoming clearer.…”

“…Harada et al [26,27] reported that the most common complication with hand symptoms after ARCR is flexor tenosynovitis https://doi.org/10.5397/cise.2021.00080…”