Predicting Pain and Disability After Shoulder Arthroscopy

Simon, Corey B.; Coronado, Rogelio A.; Greenfield, Warren H.; Valencia, Carolina; Wright, Thomas W.; Moser, Michael W.; Farmer, Kevin W.; George, Steven Z.

doi:10.1097/ajp.0000000000000267

Cited by 5 publications

(1 citation statement)

References 45 publications

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“…However, none of these studies comparing the two techniques have focused on the change of postoperative pain, but rather they simply reported the Visual Analog Scale (VAS) scores for pain at the final follow‐up visit. Meanwhile, information regarding the postoperative pain after rotator cuff repairs provided by the current literature is limited and is mainly concerned with the early postoperative period [8, 22, 33]. Hence, this study aimed to investigate the differences in postoperative pain patterns between two techniques and to augment the understanding of residual pain after rotator cuff repairs.…”

Section: Introductionmentioning

confidence: 99%

Double-row rotator cuff repairs lead to more intensive pain during the early postoperative period but have a lower risk of residual pain than single-row repairs

Chen

Qiao

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose of this study is to compare pain patterns and identify factors associated with residual shoulder pain after rotator cuf repairs using double-row and single-row techniques. Methods A cohort study was performed using patients who underwent arthroscopic rotator cuf repairs at our center in 2015. Patients were allocated according to the repair technique into an single-row (SR) group or a double-row (DR) group. Visual Analog Scale (VAS) scores for pain were assessed at 1 week, 3 months, 6 months, 12 months and 24 months after surgery. Functional and radiographic assessments were performed at least 24 months postoperatively. The proportion of patients with residual pain and factors associated with residual shoulder pain (VAS > 0 at the inal follow-up) were analyzed in both groups. Results Fifty-two patients were enrolled in the SR group, and 53 were enrolled in the DR group. The DR group appeared to have higher levels of pain 1 week (P < 0.001) and 3 months (P = 0.041) postoperatively, while at other time points, the pain intensity of the two groups was comparable. Fourteen (26.4%) and 25 (48.1%) patients in the DR and the SR groups, respectively, developed residual shoulder pain, (P = 0.022; RR 1.82). The univariate analysis and multiple regression revealed that a poorer quality of tendon tissue is related to residual pain in the SR group, whereas tendon retraction is associated with residual pain in the DR group. The rate of re-tear was similar between the two groups and between patients with and without residual pain. Conclusions The DR repair technique results in a greater intensity of pain than that of SR repair during the irst 3 months after surgery; however, patients who underwent DR repair presented a signiicantly lower proportion of residual shoulder pain and better tendon quality after 2 years. Poorer tendon quality and larger tendon retraction as determined intraoperatively were risk factors for residual pain. These results highlight the necessity of promoting healing on the grounds of residual pain prevention. Level of evidence II.

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Section: Introductionmentioning

confidence: 99%

Double-row rotator cuff repairs lead to more intensive pain during the early postoperative period but have a lower risk of residual pain than single-row repairs

Chen

Qiao

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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Biopsychosocial Influences on Shoulder Pain: Analyzing the Temporal Ordering of Postoperative Recovery

Simon

Valencia

Coronado

et al. 2020

The Journal of Pain

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Shoulder surgery is a primary intervention for shoulder pain, yet many individuals experience persistent postoperative pain. Previously, we found individuals categorized as having a high-risk phenotype (comprised of COMT variation and pain catastrophizing) had approximately double the chance of not reaching a 12-month pain recovery criterion. As a means to better understand the development of persistent postoperative shoulder pain, this study advanced our previous work by examining temporal ordering of postoperative shoulder recovery based on potential mediating factors, and expansion of outcomes to include movement-evoked pain and shoulder active range of motion. Before surgery, individuals were categorized as either high-risk (high pain catastrophizing, COMT-genotype linked to low enzyme activity [n = 41]) or low-risk (low pain catastrophizing, COMT-genotype linked to normal enzyme activity [n = 107]). We then compared potential mediating variables at 3, 6, and 12 months postoperatively 1) endogenous pain modulation defined by a conditioned pain modulation paradigm; and 2) and emotion factors such as anxiety, fear of movement, and depressive symptoms. At 3 months, the high-risk subgroup had higher fear and movement-evoked pain, and causal mediation analysis confirmed the direct effect of risk subgroup on 12-month movement evoked pain. However, baseline to 12-month change in depressive symptoms were found to mediate 53% of the total effect of risk subgroup on 12-month movement-evoked pain. This study introduces potential temporal components and relationships to the development of persistent postoperative shoulder pain, which future studies will confirm and assess for potential therapeutic targets. Perspective: This study expands upon postoperative shoulder recovery measures to include movement-evoked pain and depressive symptoms, and provides preliminary indication of temporal ordering to postoperative shoulder recovery for a preidentified high-risk subgroup. Future studies will distinguish temporal components of shoulder surgery that may optimize treatment targets of postoperative recovery.

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Pain associated psychological distress is more strongly associated with shoulder pain and function than tear severity in patients undergoing rotator cuff repair

Okafor¹,

Levin²,

Boadi³

et al. 2023

JSES International

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Predicting Pain and Disability After Shoulder Arthroscopy

Cited by 5 publications

References 45 publications

Double-row rotator cuff repairs lead to more intensive pain during the early postoperative period but have a lower risk of residual pain than single-row repairs

Double-row rotator cuff repairs lead to more intensive pain during the early postoperative period but have a lower risk of residual pain than single-row repairs

Biopsychosocial Influences on Shoulder Pain: Analyzing the Temporal Ordering of Postoperative Recovery

Pain associated psychological distress is more strongly associated with shoulder pain and function than tear severity in patients undergoing rotator cuff repair

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