Are Psychologic Factors Associated With Shoulder Scores After Rotator Cuff Surgery?

Area of Science:

• Orthopedic Surgery
• Psychology
• Rehabilitation Medicine

Background:

• Psychological factors significantly influence chronic shoulder pain and disability.
• Existing research on affective psychological factors' impact on post-shoulder surgery outcomes is conflicting.
• The relationship between cognitive psychological factors and post-shoulder surgery outcomes remains unexplored.

Purpose of the Study:

• To identify distinct clusters of psychological functioning in patients undergoing shoulder surgery.
• To determine if poorer psychological functioning correlates with worse patient outcomes, specifically the American Shoulder and Elbow Surgeons (ASES) score.

Main Methods:

• A prospective cohort study of 137 patients undergoing shoulder surgery for rotator cuff issues.
• Latent class analysis was used to group patients based on four pre-operative psychological measures.
• Linear mixed models assessed the association between psychological clusters and ASES scores over 12 months post-surgery.

Main Results:

• Two psychological clusters were identified: one with better functioning (68%) and one with poorer functioning (32%).
• Poorer psychological functioning was independently associated with significantly worse ASES scores at pre-surgery, 3 months, and 12 months post-surgery.
• Both groups demonstrated significant improvement in ASES scores over 12 months, with no difference in the magnitude of improvement between clusters.

Conclusions:

• Patients with poorer pre-operative psychological functioning experience worse outcomes after shoulder surgery.
• Pre-operative screening for psychological factors is recommended to identify at-risk patients.
• Further research is needed to establish optimal psychological interventions to enhance recovery and manage pain.