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Updated: Jun 8, 2025
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
Understanding the Multifactorial Influences on Postsurgical Pain After Rotator Cuff Repair: A Retrospective Cohort
Asimina Lazaridou1,2, Daniela Brune1, Tim Schneller1
1Department for Shoulder and Elbow Surgery, Schulthess Clinic, Zürich, Switzerland.
Background:
The experience of chronic postsurgical pain (CPSP) can vary widely among patients after rotator cuff repair (RCR).
Purpose:
To determine the prevalence and predictive factors of CPSP at 6 months after RCR.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
The following assessments were conducted preoperatively and 6 months postoperatively in adult patients with RCR who had undergone primary arthroscopic RCR (N = 1987): Constant score, pain assessed on the numeric rating scale (0-10), the Subjective Shoulder Value, the Oxford Shoulder Score, and quality of life as measured by the EuroQol-5 Dimensions-5 Level (EQ-5D-5L). Patient characteristics-including age, sex, body mass index, and smoking status-and surgical factors-including the duration of surgery and the American Society of Anesthesiologists (ASA) classification-were also reported. Multivariate logistic regression analysis was performed to determine which variables were predictors for CPSP.
Results:
The prevalence of moderate to severe preoperative pain in the patients was 30.4% for CPSP. After adjusting for age, surgery duration, ASA classification, sex, and body mass index, results revealed that unique predictors for CPSP were as follows: (1) the presence of preoperative negative affect-assessed using the anxiety/depression dimension of the EQ-5D-5L (odds ratio [OR], 1.46 (P < .001); (2) preoperative pain (OR, 1.17; P < .001); and (3) shoulder function (OR, 0.96; P < .001). None of the surgical factors appeared to predict CPSP.
Conclusion:
Patients predisposed to CPSP can be identified during the preoperative phase. Collectively, there is a call for a more in-depth assessment of biopsychosocial risk factors that could substantially influence the postoperative pain experience.
