Factors Related to Pain in Patients With Retorn Rotator Cuffs: Early Postoperative Pain Predicts Pain at 12 Months Postoperatively

Overview

Journal Orthop J Sports Med

Specialty Orthopedics

Date 2020 Sep 23

PMID 32964060

Authors

Yang-Soo Kim

Ki-Ho Kang

Hyo-Jin Lee

Affiliations

Soon will be listed here.

Abstract

Background: Retearing of a repaired rotator cuff leads to diverse symptoms, including pain, regardless of the degree of the tear, but the relationship between pain and retears is poorly understood.

Purpose: To determine which factors are correlated with shoulder pain in retears of a repaired rotator cuff.

Study Design: Case-control study; Level of evidence, 3.

Methods: We retrospectively reviewed a cohort of patients who were diagnosed as having a retear on magnetic resonance imaging after primary rotator cuff repair. The primary outcome variable of interest was the visual analog scale (VAS) for pain score at 12-month and final follow-up (mean, 25.2 months). We evaluated the relationship of pain at 12-month and final follow-up with preoperative patient factors (age, sex, and underlying conditions), preoperative range of motion, and preoperative pain; postoperative pain at 3 and 6 months; and perioperative conditions (tear extent, tear size, accompanying lesions, and procedures other than rotator cuff repair).

Results: A total of 48 patients were reviewed. The VAS score at 3 months postoperatively showed a positive correlation with the VAS score at 12 months postoperatively (ρ = 0.537; < .001) and at final follow-up (ρ = 0.537; < .001). Univariate and multivariate regression analyses revealed that the VAS score at 3 months postoperatively ( = .0001 and = .0017, respectively), hypertension ( = .0108 and = .0073, respectively), and late detection of the retear ( = .0091 and = .0208, respectively) were significant predictors of pain at 12 months postoperatively.

Conclusion: The presence of pain in the early postoperative period, underlying hypertension, and late detection of the retear were related to pain severity in patients 12 months after rotator cuff surgery.

References

Fukuda H . The management of partial-thickness tears of the rotator cuff. J Bone Joint Surg Br. 2003; 85(1):3-11. DOI: 10.1302/0301-620x.85b1.13846. View

Hein J, Reilly J, Chae J, Maerz T, Anderson K . Retear Rates After Arthroscopic Single-Row, Double-Row, and Suture Bridge Rotator Cuff Repair at a Minimum of 1 Year of Imaging Follow-up: A Systematic Review. Arthroscopy. 2015; 31(11):2274-81. DOI: 10.1016/j.arthro.2015.06.004. View

Galatz L, Ball C, Teefey S, Middleton W, Yamaguchi K . The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am. 2004; 86(2):219-24. DOI: 10.2106/00004623-200402000-00002. View

Calvert P, Packer N, STOKER D, Bayley J, Kessel L . Arthrography of the shoulder after operative repair of the torn rotator cuff. J Bone Joint Surg Br. 1986; 68(1):147-50. DOI: 10.1302/0301-620X.68B1.3941132. View

Kuroyanagi Y, Nagura T, Matsumoto H, Otani T, Toyama Y, Suda Y . Weight-bearing flexion angle correlates significantly with severity of knee osteoarthritis. Knee. 2009; 16(5):371-4. DOI: 10.1016/j.knee.2009.01.003. View

Fukuda H . Partial-thickness rotator cuff tears: a modern view on Codman's classic. J Shoulder Elbow Surg. 2000; 9(2):163-8. View

Gschwend N, Patte D . Rotator cuff tear--relationship between clinical and anatomopathological findings. Arch Orthop Trauma Surg (1978). 1988; 107(1):7-15. DOI: 10.1007/BF00463518. View

Sadosky A, Bushmakin A, Cappelleri J, Lionberger D . Relationship between patient-reported disease severity in osteoarthritis and self-reported pain, function and work productivity. Arthritis Res Ther. 2010; 12(4):R162. PMC: 2945065. DOI: 10.1186/ar3121. View

Liu S . Arthroscopically-assisted rotator-cuff repair. J Bone Joint Surg Br. 1994; 76(4):592-5. View

10.

Montgomery S, Petrigliano F, Gamradt S . Failed rotator cuff surgery, evaluation and decision making. Clin Sports Med. 2012; 31(4):693-712. DOI: 10.1016/j.csm.2012.07.006. View

11.

Anderson K, Boothby M, Aschenbrener D, van Holsbeeck M . Outcome and structural integrity after arthroscopic rotator cuff repair using 2 rows of fixation: minimum 2-year follow-up. Am J Sports Med. 2006; 34(12):1899-905. DOI: 10.1177/0363546506290187. View

12.

Kim H, Caldwell J, Buza J, Fink L, Ahmad C, Bigliani L . Factors affecting satisfaction and shoulder function in patients with a recurrent rotator cuff tear. J Bone Joint Surg Am. 2014; 96(2):106-12. DOI: 10.2106/JBJS.L.01649. View

13.

Walsh M, Nelson B, Braman J, Yonke B, Obermeier M, Raja A . Platelet-rich plasma in fibrin matrix to augment rotator cuff repair: a prospective, single-blinded, randomized study with 2-year follow-up. J Shoulder Elbow Surg. 2018; 27(9):1553-1563. DOI: 10.1016/j.jse.2018.05.003. View

14.

Xu Y, Bonar F, Murrell G . Neoinnervation in rotator cuff tendinopathy. Sports Med Arthrosc Rev. 2011; 19(4):354-9. DOI: 10.1097/JSA.0b013e318229d7e3. View

15.

Maixner W, Fillingim R, Kincaid S, Sigurdsson A, Harris M . Relationship between pain sensitivity and resting arterial blood pressure in patients with painful temporomandibular disorders. Psychosom Med. 1997; 59(5):503-11. DOI: 10.1097/00006842-199709000-00007. View

16.

Wulker N, Melzer C, Wirth C . Shoulder surgery for rotator cuff tears. Ultrasonographic 3-year follow-up of 97 cases. Acta Orthop Scand. 1991; 62(2):142-7. DOI: 10.3109/17453679108999243. View

17.

Harryman 2nd D, Mack L, Wang K, Jackins S, Richardson M, Matsen 3rd F . Repairs of the rotator cuff. Correlation of functional results with integrity of the cuff. J Bone Joint Surg Am. 1991; 73(7):982-9. View

18.

Kim Y, Lee H, Park I . Clinical outcomes do not support arthroscopic posterior capsular release in addition to anterior release for shoulder stiffness: a randomized controlled study. Am J Sports Med. 2014; 42(5):1143-9. DOI: 10.1177/0363546514523720. View

19.

Dunn W, Kuhn J, Sanders R, An Q, Baumgarten K, Bishop J . Symptoms of pain do not correlate with rotator cuff tear severity: a cross-sectional study of 393 patients with a symptomatic atraumatic full-thickness rotator cuff tear. J Bone Joint Surg Am. 2014; 96(10):793-800. PMC: 4018774. DOI: 10.2106/JBJS.L.01304. View

20.

Gazielly D, Gleyze P, Montagnon C . Functional and anatomical results after rotator cuff repair. Clin Orthop Relat Res. 1994; (304):43-53. View