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Type 1 Complex Regional Pain Syndrome After Subacromial Shoulder Surgery: Incidence and Risk Factor Analysis.

Marie Martel1, Pierre Laumonerie1, Virginie Pecourneau1

  • 1Centre Hospitalier Universitaire de Toulouse, Hôpital Pierre Paul Riquet, Place Baylac, 31059 Toulouse cedex 09, France.

Indian Journal of Orthopaedics
|September 21, 2020
PubMed
Summary

Complex Regional Pain Syndrome type 1 (CRPS1) affects over 10% of patients after shoulder surgery. Hypothyroidism, open surgery, and pre-operative physical activity are key risk factors for developing CRPS1.

Keywords:
AcromioplastyArthroscopyCRPSComplex regional pain syndromeRotator cuff repairSub-acromial surgery

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Area of Science:

  • Orthopedic Surgery
  • Pain Management
  • Musculoskeletal Disorders

Background:

  • Complex Regional Pain Syndrome type 1 (CRPS1) is a significant complication impacting functional recovery after joint procedures.
  • The incidence of CRPS1 following shoulder surgery is not well-established, with existing literature showing wide variability.
  • Understanding CRPS1 incidence and risk factors is crucial for improving patient outcomes after subacromial space surgery.

Purpose of the Study:

  • To determine the incidence of CRPS1 after extra-articular subacromial space shoulder surgery.
  • To identify pre-operative risk factors associated with the development of CRPS1 in this patient population.

Main Methods:

  • Retrospective single-center study of patients undergoing surgery for subacromial extra-articular shoulder pathology (January 2016 - December 2016).
  • Inclusion criterion: development of CRPS1 as defined by Veldman, with a minimum 6-month follow-up.
  • Pre- and post-operative clinical assessments were conducted using the Constant (Cst) score.

Main Results:

  • Out of 287 patients, 38 (13%) developed post-operative CRPS1.
  • Significant risk factors identified for CRPS1 onset include treated hypothyroidism (OR=3.79), open surgery (OR=2.92), and lower daily physical activity levels (OR=0.088).

Conclusions:

  • CRPS1 is a notable complication, affecting over 10% of patients undergoing subacromial shoulder surgery.
  • Treated hypothyroidism, open surgical approach, and pre-operative clinical status (physical activity) are significant risk factors for CRPS1.
  • These identified factors warrant consideration during pre-operative patient consultations to mitigate CRPS1 risk.