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Higher preoperative sensitivity to pain and pain at rest are associated with worse functional outcome after stemless total shoulder arthroplasty: a prospective cohort study
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Ryhov Hospital, Jönköping, Sweden.ORCID iD: 0000-0003-4698-8627
Department of Clinical Science and Education, Section of Orthopaedics, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
Department of Orthopaedics,, Ryhov Hospital, Linköping University, Jönköping, Sweden.
Department of Surgical and Perioperative Sciences and Department of Orthopaedics, Umeå University, Södersjukhuset, Stockholm, Sweden.
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2018 (English)In: The Bone & Joint Journal, ISSN 2049-4394, E-ISSN 2049-4408, Vol. 100B, no 4, p. 480-484Article in journal (Refereed) Published
Abstract [en]

Aims

The aims of this study were to investigate any possible relationship between a preoperative sensitivity to pain and the degree of pain at rest and on exertion with postoperative function in patients who underwent stemless total shoulder arthroplasty (TSA).

Patients and Methods

In this prospective study, we included 63 patients who underwent stemless TSA and were available for evaluation one year postoperatively. There were 31 women and 32 men; their mean age was 71 years (53 to 89). The pain threshold, which was measured using a Pain Matcher (PM) unit, the degree of pain (visual analogue scale at rest and on exertion, and function using the short version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH), were recorded preoperatively, as well as three and 12 months postoperatively.

Results

We found an inverse relationship between both the preoperative PM threshold and pain (VAS) at rest and the 12-month postoperative QuickDASH score (Pearson correlation coefficient (r) ≥ 0.4, p < 0.05). A linear regression analysis showed that the preoperative PM threshold on the affected side and preoperative pain (VAS) at rest were the only factors associated with the QuickDASH score at 12 months.

Conclusion

These findings indicate the importance of central sensitization in the restoration of function after TSA. Further studies are required to investigate whether extra analgesia and rehabilitation could influence the outcome in at risk patients.

Place, publisher, year, edition, pages
London, United Kingdom: British Editorial Society of Bone and Joint Surgery , 2018. Vol. 100B, no 4, p. 480-484
National Category
Orthopaedics
Identifiers
URN: urn:nbn:se:liu:diva-147813DOI: 10.1302/0301-620X.100B4.BJJ-2017-1000.R1ISI: 000429591700012PubMedID: 29629590Scopus ID: 2-s2.0-85045622346OAI: oai:DiVA.org:liu-147813DiVA, id: diva2:1206529
Available from: 2018-05-17 Created: 2018-05-17 Last updated: 2021-03-17Bibliographically approved

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Kadum, BakirSjoden, G. O.
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