Influence of Pain Sensitivity on Surgical Outcomes of Arthroscopic Rotator Cuff Repair: A Prospective Cohort Study
Background: The Pain Sensitivity Questionnaire (PSQ) has been found to be a valid tool, and PSQ scores have been shown to be predictive of outcomes after surgery for lumbar stenosis. The effect of pain sensitivity on outcomes of rotator cuff repair (RCR) surgery has not been examined. Hypothesis: PS...
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| Veröffentlicht in: | The American journal of sports medicine 2023-12, Vol.51 (14), p.3802-3809 |
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| creator | Yaari, Lee Shaul Nicholas, Stephen J. Bedford, Benjamin B. Mendez-Zfass, Matthew S. Hogan, Daniel E. Haviv, Barak McHugh, Malachy P. |
| description | Background:
The Pain Sensitivity Questionnaire (PSQ) has been found to be a valid tool, and PSQ scores have been shown to be predictive of outcomes after surgery for lumbar stenosis. The effect of pain sensitivity on outcomes of rotator cuff repair (RCR) surgery has not been examined.
Hypothesis:
PSQ scores would be associated with surgical outcomes after arthroscopic RCR surgery.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Patients 18 to 80 years old scheduled for RCR were consecutively enrolled. Patients with glenohumeral arthritis grade ≥2 or RCR revision surgery were excluded. PSQ was completed preoperatively. The Disabilities of the Arm, Shoulder and Hand score and American Shoulder and Elbow Surgeons score were used as patient-reported outcome measurements (PROMs), and visual analog scale pain score was documented as well. Active shoulder external rotation (ER), internal rotation, and anterior forward elevation range of motion (ROM) were recorded. PROMs and ROM measurements were recorded preoperatively and at 3 months, 6 months, and 1 year after surgery. Rotator cuff tear size, type of repair, and concomitant procedures were documented. Patients were classified as having high or normal pain sensitivity based on PSQ scores.
Results:
Of 100 enrolled patients, 38 patients were classified as having high pain sensitivity. Patients with high pain sensitivity had worse American Shoulder and Elbow Surgeons and Disabilities of the Arm, Shoulder and Hand scores preoperatively, 6 months postoperatively, and 1 year postoperatively (P < .01). From the preoperative assessment to 3 months postoperatively, PROMs improved more in patients with high versus normal pain sensitivity. However, for patients with high pain sensitivity, PROMs plateaued after 3 months but continued to improve for patients with normal pain sensitivity (P < .01). Visual analog scale pain scores were higher at all time points for patients with high pain sensitivity (P < .05). Preoperatively, patients with high pain sensitivity had restricted active ROM compared with patients who had normal pain sensitivity for anterior forward elevation, ER, and internal rotation (P = .009, P = .012, and P = .006, respectively). By 1 year after surgery, ER ROM was still restricted in patients with high pain sensitivity.
Conclusion:
Pain sensitivity is an important factor influencing RCR outcomes. Patients with high pain sensitivity undergoing RCR showed less improvement in active ROM and worse PRO |
| doi_str_mv | 10.1177/03635465231208113 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2891755848</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_03635465231208113</sage_id><sourcerecordid>2891755848</sourcerecordid><originalsourceid>FETCH-LOGICAL-c320t-c42addf2eaf43bedca8252d535b13b0054bc57846ecea1c10fcc4c7e03c8856a3</originalsourceid><addsrcrecordid>eNp10U1r3DAQBmBRUppt2h_QSxDk0otTfVi2ktuypG0gkJC0ZyOPR4mC13L0Edh_X5lNW0jpSQg980qaIeQTZ6ect-0XJhup6kYJyQXTnMs3ZMWVEpWUjTogq-W8WsAheR_jI2OMt41-Rw5le9YqxdsVCZeTHTNOgNRbemPcRO9wii65Z5d21JdtDvcOzEivcwK_xbjAdUgPwUfwswN665NJPtBNtpbe4mxcOKdrelPAjFCSkG78gw-J3qU87D6Qt9aMET--rEfk59eLH5vv1dX1t8vN-qoCKViqoBZmGKxAY2vZ4wBGCyUGJVXPZc-YqntQra4bBDQcOLMANbTIJGitGiOPyOd97hz8U8aYuq2LgONoJvQ5dkKf8dIFXetCT17RR5_DVF63qIaVnkpRFN8rKD-LAW03B7c1Yddx1i0D6f4ZSKk5fknO_RaHPxW_J1DA6R5Ec49_r_1_4i-9FJN7</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2896055232</pqid></control><display><type>article</type><title>Influence of Pain Sensitivity on Surgical Outcomes of Arthroscopic Rotator Cuff Repair: A Prospective Cohort Study</title><source>MEDLINE</source><source>SAGE Complete</source><source>Alma/SFX Local Collection</source><creator>Yaari, Lee Shaul ; Nicholas, Stephen J. ; Bedford, Benjamin B. ; Mendez-Zfass, Matthew S. ; Hogan, Daniel E. ; Haviv, Barak ; McHugh, Malachy P.</creator><creatorcontrib>Yaari, Lee Shaul ; Nicholas, Stephen J. ; Bedford, Benjamin B. ; Mendez-Zfass, Matthew S. ; Hogan, Daniel E. ; Haviv, Barak ; McHugh, Malachy P.</creatorcontrib><description>Background:
The Pain Sensitivity Questionnaire (PSQ) has been found to be a valid tool, and PSQ scores have been shown to be predictive of outcomes after surgery for lumbar stenosis. The effect of pain sensitivity on outcomes of rotator cuff repair (RCR) surgery has not been examined.
Hypothesis:
PSQ scores would be associated with surgical outcomes after arthroscopic RCR surgery.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Patients 18 to 80 years old scheduled for RCR were consecutively enrolled. Patients with glenohumeral arthritis grade ≥2 or RCR revision surgery were excluded. PSQ was completed preoperatively. The Disabilities of the Arm, Shoulder and Hand score and American Shoulder and Elbow Surgeons score were used as patient-reported outcome measurements (PROMs), and visual analog scale pain score was documented as well. Active shoulder external rotation (ER), internal rotation, and anterior forward elevation range of motion (ROM) were recorded. PROMs and ROM measurements were recorded preoperatively and at 3 months, 6 months, and 1 year after surgery. Rotator cuff tear size, type of repair, and concomitant procedures were documented. Patients were classified as having high or normal pain sensitivity based on PSQ scores.
Results:
Of 100 enrolled patients, 38 patients were classified as having high pain sensitivity. Patients with high pain sensitivity had worse American Shoulder and Elbow Surgeons and Disabilities of the Arm, Shoulder and Hand scores preoperatively, 6 months postoperatively, and 1 year postoperatively (P < .01). From the preoperative assessment to 3 months postoperatively, PROMs improved more in patients with high versus normal pain sensitivity. However, for patients with high pain sensitivity, PROMs plateaued after 3 months but continued to improve for patients with normal pain sensitivity (P < .01). Visual analog scale pain scores were higher at all time points for patients with high pain sensitivity (P < .05). Preoperatively, patients with high pain sensitivity had restricted active ROM compared with patients who had normal pain sensitivity for anterior forward elevation, ER, and internal rotation (P = .009, P = .012, and P = .006, respectively). By 1 year after surgery, ER ROM was still restricted in patients with high pain sensitivity.
Conclusion:
Pain sensitivity is an important factor influencing RCR outcomes. Patients with high pain sensitivity undergoing RCR showed less improvement in active ROM and worse PROMs after surgery compared with patients who had normal pain sensitivity. Preoperative PSQ may predict postoperative improvements.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/03635465231208113</identifier><identifier>PMID: 37975517</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Arthroscopy - methods ; Cohort analysis ; Cohort Studies ; Humans ; Middle Aged ; Pain ; Prospective Studies ; Range of Motion, Articular ; Retrospective Studies ; Rotator cuff ; Rotator Cuff - surgery ; Rotator Cuff Injuries - complications ; Rotator Cuff Injuries - surgery ; Sports medicine ; Surgeons ; Surgery ; Surgical outcomes ; Treatment Outcome ; Young Adult</subject><ispartof>The American journal of sports medicine, 2023-12, Vol.51 (14), p.3802-3809</ispartof><rights>2023 The Author(s)</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c320t-c42addf2eaf43bedca8252d535b13b0054bc57846ecea1c10fcc4c7e03c8856a3</cites><orcidid>0000-0002-8371-8151</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/03635465231208113$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/03635465231208113$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37975517$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yaari, Lee Shaul</creatorcontrib><creatorcontrib>Nicholas, Stephen J.</creatorcontrib><creatorcontrib>Bedford, Benjamin B.</creatorcontrib><creatorcontrib>Mendez-Zfass, Matthew S.</creatorcontrib><creatorcontrib>Hogan, Daniel E.</creatorcontrib><creatorcontrib>Haviv, Barak</creatorcontrib><creatorcontrib>McHugh, Malachy P.</creatorcontrib><title>Influence of Pain Sensitivity on Surgical Outcomes of Arthroscopic Rotator Cuff Repair: A Prospective Cohort Study</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background:
The Pain Sensitivity Questionnaire (PSQ) has been found to be a valid tool, and PSQ scores have been shown to be predictive of outcomes after surgery for lumbar stenosis. The effect of pain sensitivity on outcomes of rotator cuff repair (RCR) surgery has not been examined.
Hypothesis:
PSQ scores would be associated with surgical outcomes after arthroscopic RCR surgery.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Patients 18 to 80 years old scheduled for RCR were consecutively enrolled. Patients with glenohumeral arthritis grade ≥2 or RCR revision surgery were excluded. PSQ was completed preoperatively. The Disabilities of the Arm, Shoulder and Hand score and American Shoulder and Elbow Surgeons score were used as patient-reported outcome measurements (PROMs), and visual analog scale pain score was documented as well. Active shoulder external rotation (ER), internal rotation, and anterior forward elevation range of motion (ROM) were recorded. PROMs and ROM measurements were recorded preoperatively and at 3 months, 6 months, and 1 year after surgery. Rotator cuff tear size, type of repair, and concomitant procedures were documented. Patients were classified as having high or normal pain sensitivity based on PSQ scores.
Results:
Of 100 enrolled patients, 38 patients were classified as having high pain sensitivity. Patients with high pain sensitivity had worse American Shoulder and Elbow Surgeons and Disabilities of the Arm, Shoulder and Hand scores preoperatively, 6 months postoperatively, and 1 year postoperatively (P < .01). From the preoperative assessment to 3 months postoperatively, PROMs improved more in patients with high versus normal pain sensitivity. However, for patients with high pain sensitivity, PROMs plateaued after 3 months but continued to improve for patients with normal pain sensitivity (P < .01). Visual analog scale pain scores were higher at all time points for patients with high pain sensitivity (P < .05). Preoperatively, patients with high pain sensitivity had restricted active ROM compared with patients who had normal pain sensitivity for anterior forward elevation, ER, and internal rotation (P = .009, P = .012, and P = .006, respectively). By 1 year after surgery, ER ROM was still restricted in patients with high pain sensitivity.
Conclusion:
Pain sensitivity is an important factor influencing RCR outcomes. Patients with high pain sensitivity undergoing RCR showed less improvement in active ROM and worse PROMs after surgery compared with patients who had normal pain sensitivity. Preoperative PSQ may predict postoperative improvements.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arthroscopy - methods</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>Pain</subject><subject>Prospective Studies</subject><subject>Range of Motion, Articular</subject><subject>Retrospective Studies</subject><subject>Rotator cuff</subject><subject>Rotator Cuff - surgery</subject><subject>Rotator Cuff Injuries - complications</subject><subject>Rotator Cuff Injuries - surgery</subject><subject>Sports medicine</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10U1r3DAQBmBRUppt2h_QSxDk0otTfVi2ktuypG0gkJC0ZyOPR4mC13L0Edh_X5lNW0jpSQg980qaIeQTZ6ect-0XJhup6kYJyQXTnMs3ZMWVEpWUjTogq-W8WsAheR_jI2OMt41-Rw5le9YqxdsVCZeTHTNOgNRbemPcRO9wii65Z5d21JdtDvcOzEivcwK_xbjAdUgPwUfwswN665NJPtBNtpbe4mxcOKdrelPAjFCSkG78gw-J3qU87D6Qt9aMET--rEfk59eLH5vv1dX1t8vN-qoCKViqoBZmGKxAY2vZ4wBGCyUGJVXPZc-YqntQra4bBDQcOLMANbTIJGitGiOPyOd97hz8U8aYuq2LgONoJvQ5dkKf8dIFXetCT17RR5_DVF63qIaVnkpRFN8rKD-LAW03B7c1Yddx1i0D6f4ZSKk5fknO_RaHPxW_J1DA6R5Ec49_r_1_4i-9FJN7</recordid><startdate>202312</startdate><enddate>202312</enddate><creator>Yaari, Lee Shaul</creator><creator>Nicholas, Stephen J.</creator><creator>Bedford, Benjamin B.</creator><creator>Mendez-Zfass, Matthew S.</creator><creator>Hogan, Daniel E.</creator><creator>Haviv, Barak</creator><creator>McHugh, Malachy P.</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8371-8151</orcidid></search><sort><creationdate>202312</creationdate><title>Influence of Pain Sensitivity on Surgical Outcomes of Arthroscopic Rotator Cuff Repair: A Prospective Cohort Study</title><author>Yaari, Lee Shaul ; Nicholas, Stephen J. ; Bedford, Benjamin B. ; Mendez-Zfass, Matthew S. ; Hogan, Daniel E. ; Haviv, Barak ; McHugh, Malachy P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c320t-c42addf2eaf43bedca8252d535b13b0054bc57846ecea1c10fcc4c7e03c8856a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arthroscopy - methods</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Humans</topic><topic>Middle Aged</topic><topic>Pain</topic><topic>Prospective Studies</topic><topic>Range of Motion, Articular</topic><topic>Retrospective Studies</topic><topic>Rotator cuff</topic><topic>Rotator Cuff - surgery</topic><topic>Rotator Cuff Injuries - complications</topic><topic>Rotator Cuff Injuries - surgery</topic><topic>Sports medicine</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yaari, Lee Shaul</creatorcontrib><creatorcontrib>Nicholas, Stephen J.</creatorcontrib><creatorcontrib>Bedford, Benjamin B.</creatorcontrib><creatorcontrib>Mendez-Zfass, Matthew S.</creatorcontrib><creatorcontrib>Hogan, Daniel E.</creatorcontrib><creatorcontrib>Haviv, Barak</creatorcontrib><creatorcontrib>McHugh, Malachy P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yaari, Lee Shaul</au><au>Nicholas, Stephen J.</au><au>Bedford, Benjamin B.</au><au>Mendez-Zfass, Matthew S.</au><au>Hogan, Daniel E.</au><au>Haviv, Barak</au><au>McHugh, Malachy P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of Pain Sensitivity on Surgical Outcomes of Arthroscopic Rotator Cuff Repair: A Prospective Cohort Study</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2023-12</date><risdate>2023</risdate><volume>51</volume><issue>14</issue><spage>3802</spage><epage>3809</epage><pages>3802-3809</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><abstract>Background:
The Pain Sensitivity Questionnaire (PSQ) has been found to be a valid tool, and PSQ scores have been shown to be predictive of outcomes after surgery for lumbar stenosis. The effect of pain sensitivity on outcomes of rotator cuff repair (RCR) surgery has not been examined.
Hypothesis:
PSQ scores would be associated with surgical outcomes after arthroscopic RCR surgery.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Patients 18 to 80 years old scheduled for RCR were consecutively enrolled. Patients with glenohumeral arthritis grade ≥2 or RCR revision surgery were excluded. PSQ was completed preoperatively. The Disabilities of the Arm, Shoulder and Hand score and American Shoulder and Elbow Surgeons score were used as patient-reported outcome measurements (PROMs), and visual analog scale pain score was documented as well. Active shoulder external rotation (ER), internal rotation, and anterior forward elevation range of motion (ROM) were recorded. PROMs and ROM measurements were recorded preoperatively and at 3 months, 6 months, and 1 year after surgery. Rotator cuff tear size, type of repair, and concomitant procedures were documented. Patients were classified as having high or normal pain sensitivity based on PSQ scores.
Results:
Of 100 enrolled patients, 38 patients were classified as having high pain sensitivity. Patients with high pain sensitivity had worse American Shoulder and Elbow Surgeons and Disabilities of the Arm, Shoulder and Hand scores preoperatively, 6 months postoperatively, and 1 year postoperatively (P < .01). From the preoperative assessment to 3 months postoperatively, PROMs improved more in patients with high versus normal pain sensitivity. However, for patients with high pain sensitivity, PROMs plateaued after 3 months but continued to improve for patients with normal pain sensitivity (P < .01). Visual analog scale pain scores were higher at all time points for patients with high pain sensitivity (P < .05). Preoperatively, patients with high pain sensitivity had restricted active ROM compared with patients who had normal pain sensitivity for anterior forward elevation, ER, and internal rotation (P = .009, P = .012, and P = .006, respectively). By 1 year after surgery, ER ROM was still restricted in patients with high pain sensitivity.
Conclusion:
Pain sensitivity is an important factor influencing RCR outcomes. Patients with high pain sensitivity undergoing RCR showed less improvement in active ROM and worse PROMs after surgery compared with patients who had normal pain sensitivity. Preoperative PSQ may predict postoperative improvements.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>37975517</pmid><doi>10.1177/03635465231208113</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-8371-8151</orcidid></addata></record> |
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| identifier | ISSN: 0363-5465 |
| ispartof | The American journal of sports medicine, 2023-12, Vol.51 (14), p.3802-3809 |
| issn | 0363-5465 1552-3365 |
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| source | MEDLINE; SAGE Complete; Alma/SFX Local Collection |
| subjects | Adolescent Adult Aged Aged, 80 and over Arthroscopy - methods Cohort analysis Cohort Studies Humans Middle Aged Pain Prospective Studies Range of Motion, Articular Retrospective Studies Rotator cuff Rotator Cuff - surgery Rotator Cuff Injuries - complications Rotator Cuff Injuries - surgery Sports medicine Surgeons Surgery Surgical outcomes Treatment Outcome Young Adult |
| title | Influence of Pain Sensitivity on Surgical Outcomes of Arthroscopic Rotator Cuff Repair: A Prospective Cohort Study |
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