Predictors of pain and functional outcomes after operative treatment for rotator cuff tears
Autor: | Nitin B. Jain, Run Fan, Elizabeth Matzkin, Gregory D. Ayers, Keith M. Baumgarten, John E. Kuhn, Laurence D. Higgins |
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Rok vydání: | 2017 |
Předmět: |
Male
medicine.medical_specialty Article Rotator Cuff Injuries 03 medical and health sciences Rotator Cuff 0302 clinical medicine Shoulder Pain Surveys and Questionnaires medicine Humans Orthopedics and Sports Medicine Rotator cuff 030212 general & internal medicine Longitudinal cohort Range of Motion Articular Aged Rupture 030222 orthopedics medicine.diagnostic_test business.industry Shoulder Joint Magnetic resonance imaging General Medicine Surgical procedures Middle Aged Prognosis Magnetic Resonance Imaging medicine.anatomical_structure Treatment Outcome Cuff Cohort Physical therapy Tears Surgery Female business Patient education |
Zdroj: | Journal of shoulder and elbow surgery. 27(8) |
ISSN: | 1532-6500 |
Popis: | BACKGROUND: Optimal patient selection is key to success of operative treatment for cuff tears. We assessed predictors of pain and functional outcomes in a longitudinal cohort of patients undergoing operative treatment. METHODS: From 03/2011 to 01/2015, a cohort of patients with rotator cuff tears undergoing rotator cuff surgery was recruited. Patients completed a detailed health and demographic questionnaire, standardized shoulder questionnaires including the Shoulder Pain and Disability Index (SPADI), and underwent a MRI. Patients received follow-up questionnaires at 3, 6, 12, and 18 months. We assessed longitudinal predictors of SPADI using longitudinal mixed models. Interactions with follow-up duration after surgery were also assessed. RESULTS: In our analysis (n=50), a lower fear-avoidance beliefs questionnaire physical activity score (FABQ; p=0.001) predicted a lower SPADI score (better shoulder pain and function). Those consuming alcohol 1–2 times per week or more had lower SPADI scores as compared with those consuming alcohol 2–3 times per month or less (p=0.017). Both of these variables had a significant interaction with duration of follow-up. Other variables including socio-demographic characteristics, MRI characteristics such as tear size and muscle quality, shoulder strength, and variations in surgical techniques/performance of adjuvant surgical procedures were not significant predictors of SPADI. CONCLUSIONS: Those with higher fear avoidance behavior and alcohol use of 1–2 times/week had worse shoulder pain and function at 18 months of follow-up. These data can be used to select optimal candidates for operative treatment of rotator cuff tears and assist with patient education and expectations prior to treatment. LEVEL OF EVIDENCE: Level II; Prospective Cohort Design; Treatment Study |
Databáze: | OpenAIRE |
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