Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Clinical outcome in patients with hand lesions associated with complex regional pain syndrome after arthroscopic rotator cuff repair

  • Imai, Takaki (Department of Rehabilitation, Kyushu University of Nursing and Social Welfare) ;
  • Gotoh, Masafumi (Department of Orthopedic Surgery, Kurume University Medical Center) ;
  • Fukuda, Keiji (Department of Orthopedic Surgery, Keishinkai Hospital) ;
  • Ogino, Misa (Department of Orthopedic Surgery, Keishinkai Hospital) ;
  • Nakamura, Hidehiro (Department of Orthopedic Surgery, Kurume University Medical Center) ;
  • Ohzono, Hiroki (Department of Orthopedic Surgery, Kurume University) ;
  • Shiba, Naoto (Department of Orthopedic Surgery, Kurume University) ;
  • Okawa, Takahiro (Department of Orthopedic Surgery, Kurume University Medical Center)
  • Received : 2021.02.08
  • Accepted : 2021.03.18
  • Published : 2021.06.01
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Abstract

Background: Complex regional pain syndrome (CRPS)-related hand lesions are one of the complications following arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the clinical outcomes of patients with CRPS-related hand lesions following ARCR. Methods: Altogether, 103 patients with ARCR were included in this study (mean age, 63.6±8.2 years; 66 males and 37 females; follow-up period, preoperative to 12 months postoperative). Clinical assessment included the Japanese Orthopaedic Association (JOA) score, University of California, Los Angeles (UCLA) score, Constant score, 36-item short form health survey (SF-36) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score from preoperative to 12 months postoperatively. The patients were either assigned to the CRPS group or non-CRPS group depending on CRPS diagnosis until the final follow-up, and clinical outcomes were then compared between the groups. Results: Of 103 patients, 20 (19.4%) had CRPS-related hand lesions that developed entirely within 2 months postoperatively. Both groups showed significant improvement in JOA, UCLA, and Constant scores preoperatively to 12 months postoperatively (p<001). Comparisons between the two groups were not significantly different, except for SF-36 "general health perception" (p<0.05) at 12 months postoperatively. At final follow-up, three patients had residual CRPS-related hand lesions with limited range of motion and finger edema. Conclusions: CRPS-related hand lesions developed in 19.4% of patients following ARCR. Shoulder or upper-limb function improved in most cases at 12 months, with satisfactory SF-36 patient-based evaluation results. Patients with residual CRPS-related hand lesions at the last follow-up require long-term follow-up.

Keywords

References

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