DOS 2017

DOS Kongressen 2017 ·

Predictors of pain six months after arthroscopic shoul-

der surgery

Lone Dragnes Brix, Theis Muncholm Thillemann, Karen Toftdahl Bjørnholdt, Lone

Nikolajsen

Anaesthesiology, Horsens Regional Hospital; Orthopaedic Surgery, Aarhus Uni-

versity Hospital; Orthopaedic Surgery, Horsens Regional Hospital; Operation

and intensive care North, South and East, Aarhus University Hospital

Background:

Arthroscopic shoulder surgery, e.g. subacromial decompression

(ASD) and acromioclavicular resection (AC resection ), usually results in signifi-

cant improvement in pain and shoulder function; however some patients report

persistent pain after shoulder surgery.

Purpose / Aim of Study:

Thus, the aims of this prospective study were 1)

to determine the incidence of pain six months after outpatient ASD and/or AC

resection, and 2) to identify risk factors for persistent pain.

Materials and Methods:

One-hundred-and-fifty patients completed West-

ern Ontario Rotator Cuff Index (WORC), Single Assessment Numeric Evaluation

(SANE), State-Trait Anxiety FORM Y (STAI), Hospital Anxiety and Depression

Scale (HADS), and Pain Catastrophizing Scale (PCS) and were tested for en-

dogenous pain modulation capacity. Patients with pain six months after surgery

(pain intensity ≥3 on a numeric rating scale with impact on daily living) were

examined by an experienced orthopaedic surgeon to identify the reasons for

persistent pain.

Findings / Results:

Data from 101 patients were available for analysis six

months after surgery. Thirty-six patients (35.6%) had pain, with the surgeon

able to identify reasons for the pain in ten patients (9.9%). Predictors of unex-

plained persistent pain included unemployment, ongoing insurance case, and a

high t-STAI-score.

Conclusions:

Persistent pain was prevalent in 35.6% of patients six months

after ASD and/or AC resection, but this number was reduced after excluding

patients with identified reasons for the pain. Several preoperative risk factors

were identified. Thus, the current data highlights the importance of careful pa-

tient selection before surgery and of patient follow-up after surgery.

No conflicts of interest reported

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