Corey B Simon1, Rogelio A Coronado, Warren H Greenfield, Carolina Valencia, Thomas W Wright, Michael W Moser, Kevin W Farmer, Steven Z George. 1. *Pain Research & Intervention Center of Excellence †Department of Physical Therapy, College of Public Health and Health Professions ∥Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL ‡Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University, Nashville, TN §Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute, IN.
Abstract
OBJECTIVES: Study the influence of concomitant arthroscopic procedures and rotator cuff tear (RCT) severity on daily pain intensity and disability after shoulder arthroscopy. MATERIALS AND METHODS: A sample of 145 patients (mean age, 42.66±17.6; number of males=96) completed daily pain intensity and disability measures before shoulder arthroscopy. RCT severity was assessed on a 7-point scale based on operative report. Operative procedures were categorized based on anatomic location and invasiveness to calculate a weighted concomitant procedure estimate. Postoperative daily pain and disability were assessed 3 months, 6 months, and 1 year status after surgery. RESULTS: Only concomitant procedures were associated with 3-month daily pain intensity after adjusting for age, sex, pain duration, and baseline daily pain intensity (R=0.03; standardized β=0.203; P=0.036). Moreover, post hoc analysis revealed concomitant procedures remained predictive of 3-month daily pain intensity when the estimate was calculated independent of RCT procedures (R=0.05; standardized β=0.233; P=0.007), and when accounting for postoperative factors of physical therapy and analgesic medication (R=0.05; standardized β=0.237; P=0.007). Neither RCT severity nor concomitant procedures were predictive of daily pain intensity at 6 months and 1 year, or disability at any time-point, in the adjusted models (P>0.05). DISCUSSION: This study introduces a novel means for estimating concurrent procedures for use as a prognostic factor. Our findings are similar to previous research of RCT severity that was found to have limited influence on postoperative outcomes. In contrast, this study highlights the potential importance of accounting for concomitant arthroscopic procedures as a predictor of early postoperative pain intensity outcomes.
OBJECTIVES: Study the influence of concomitant arthroscopic procedures and rotator cuff tear (RCT) severity on daily pain intensity and disability after shoulder arthroscopy. MATERIALS AND METHODS: A sample of 145 patients (mean age, 42.66±17.6; number of males=96) completed daily pain intensity and disability measures before shoulder arthroscopy. RCT severity was assessed on a 7-point scale based on operative report. Operative procedures were categorized based on anatomic location and invasiveness to calculate a weighted concomitant procedure estimate. Postoperative daily pain and disability were assessed 3 months, 6 months, and 1 year status after surgery. RESULTS: Only concomitant procedures were associated with 3-month daily pain intensity after adjusting for age, sex, pain duration, and baseline daily pain intensity (R=0.03; standardized β=0.203; P=0.036). Moreover, post hoc analysis revealed concomitant procedures remained predictive of 3-month daily pain intensity when the estimate was calculated independent of RCT procedures (R=0.05; standardized β=0.233; P=0.007), and when accounting for postoperative factors of physical therapy and analgesic medication (R=0.05; standardized β=0.237; P=0.007). Neither RCT severity nor concomitant procedures were predictive of daily pain intensity at 6 months and 1 year, or disability at any time-point, in the adjusted models (P>0.05). DISCUSSION: This study introduces a novel means for estimating concurrent procedures for use as a prognostic factor. Our findings are similar to previous research of RCT severity that was found to have limited influence on postoperative outcomes. In contrast, this study highlights the potential importance of accounting for concomitant arthroscopic procedures as a predictor of early postoperative pain intensity outcomes.
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Authors: Corey B Simon; Carolina Valencia; Rogelio A Coronado; Samuel S Wu; Zhigang Li; Yunfeng Dai; Kevin W Farmer; Michael M Moser; Thomas W Wright; Roger B Fillingim; Steven Z George Journal: J Pain Date: 2019-12-28 Impact factor: 5.820