Background & Aims

Rotator Cuff Repair (RCR) is a common surgical procedure aimed at alleviating shoulder pain and restoring function. However, the experience of Chronic Postsurgical Pain (CPSP) can vary widely among individuals undergoing rotator cuff repair.

Purpose: Our objective was to determine the prevalence and predictive factors of CPSP 6 months after rotator cuff repair.

Study Design: This was a retrospective longitudinal cohort study.

Cohort; Level of evidence, 3.

Methods

The following assessments were included preoperatively and 6-months postoperatively in adult rotator cuff tear patients who had undergone primary arthroscopic rotator cuff repair (N=1,988): Constant Score (CS), NRS Pain Rating (0-10), Subjective Shoulder Value), Oxford Shoulder Score (OSS) and quality of life (EQ-5D-5L; European Quality of Life 5 Dimensions 5 Level)  and demographics (e.ge age, sex, BMI, smoking) and surgical factors (e.g duration of surgery, American Society of Anesthesiologists status). Multivariate Logistic regression analysis was performed to determine which variables were predictors for CPSP.

Results

The prevalence of moderate to severe preoperative pain in patients undergoing rotator cuff repair was 30.4% for CPSP. Results revealed that unique predictors for CPSP included the presence of preoperative negative affect (symptoms of anxiety and depression; OR: 1.48, p<0.001), preoperative pain (OR: 1.17, p<0.001) and shoulder function (OR: 0.96, p<0.001) controlling for age, surgery duration, ASA classification, sex and BMI. None of the surgical factors appeared to predict CPSP.

Conclusions

Patients predisposed to CPSP can be identified during the preoperative phase. Collectively, there is call for a more in-depth assessment of biopsychosocial risk factors that could substantially influence the postoperative pain experience.

References

1. Johnson AH, York JJ, Lashgari CJ, Petre BM, Turcotte JJ, Redziniak DE. Effects of preexisting depression and anxiety on postoperative outcomes following arthroscopic rotator cuff repair. JSES Int. 2022 Aug 10;6(6):984-988. doi: 10.1016/j.jseint.2022.07.005. PMID: 36353422; PMCID: PMC9637647.
2. Longo UG, De Salvatore S, Piergentili I, Panattoni N, Marchetti A, De Marinis MG, Denaro V. Anxiety and Depressive Symptoms Correlated to Patient-Reported Outcome Measures after Rotator Cuff Repair: A Prospective Study in the Perioperative Period. J Clin Med. 2023 Apr 20;12(8):2999. doi: 10.3390/jcm12082999. PMID: 37109336; PMCID: PMC10146391.
3. Dujeux C, Antoni M, Thery C, Eichler D, Meyer N, Clavert P. History of mood and anxiety disorders does not affect the outcomes of arthroscopic rotator cuff repair. Orthop Traumatol Surg Res. 2023 Nov;109(7):103550. doi: 10.1016/j.otsr.2023.103550. Epub 2023 Jan 13. PMID: 36642405.

Presenting Author

Asimina Lazaridou

Poster Authors

Asimina Lazaridou

PhD

Brigham and Women's hospital/Harvard Medical School

Lead Author

Daniela Brune

Schulthess Klinik

Lead Author

Topics

  • Mechanisms: Psychosocial and Biopsychosocial