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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
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Which patient level factors predict persistent pain after reverse total shoulder arthroplasty?
Daniela Brune1, Steven Z George2, Robert R Edwards3
1Teaching, Research and Development Upper Extremities & Hand, Schulthess Clinic, Lengghalde 2, 8008, Zurich, Switzerland.
Journal of Orthopaedic Surgery and Research
|November 23, 2024
Summary
Persistent pain after reverse total shoulder arthroplasty (RTSA) is linked to preoperative factors like higher pain scores and anxiety. Identifying these risks can help tailor pain management for better patient outcomes.
Area of Science:
- Orthopedic Surgery
- Pain Management
- Arthroplasty Research
Background:
- Reverse total shoulder arthroplasty (RTSA) improves function for severe shoulder conditions.
- A subset of patients experience persistent pain two years post-RTSA.
- Understanding predictors of persistent pain is crucial for optimizing outcomes.
Purpose of the Study:
- To identify modifiable and non-modifiable preoperative factors associated with persistent postsurgical pain after RTSA.
- To inform targeted pain management strategies for at-risk patients.
Main Methods:
- Retrospective cohort study of 703 patients undergoing primary RTSA (2011-2022).
- Persistent postsurgical pain defined as a numeric rating scale score ≥3.
- Multivariable regression analysis to identify predictors of persistent pain.
Main Results:
- 18% of patients reported persistent postsurgical pain.
- Predictors included higher preoperative pain (β=0.10), worse QuickDASH scores (β=0.09), anxiety/depression symptoms (β=0.52), prior contralateral TSA (β=0.34), and multiple ipsilateral surgeries (β=0.44).
- Rheumatoid arthritis and primary osteoarthritis were associated with lower pain levels.
Conclusions:
- Higher preoperative pain, psychological distress, functional deficits (QuickDASH), and prior surgeries predict persistent pain post-RTSA.
- These findings aid in identifying high-risk patients for tailored interventions.
- Targeted strategies can improve long-term pain management after RTSA.
