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Erschienen in:
25.01.2019 | SHOULDER
Double-row rotator cuff repairs lead to more intensive pain during the early postoperative period but have a lower risk of residual pain than single-row repairs
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 10/2019
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Purpose
The purpose of this study is to compare pain patterns and identify factors associated with residual shoulder pain after rotator cuff repairs using double-row and single-row techniques.
Methods
A cohort study was performed using patients who underwent arthroscopic rotator cuff repairs at our center in 2015. Patients were allocated according to the repair technique into an single-row (SR) group or a double-row (DR) group. Visual Analog Scale (VAS) scores for pain were assessed at 1 week, 3 months, 6 months, 12 months and 24 months after surgery. Functional and radiographic assessments were performed at least 24 months postoperatively. The proportion of patients with residual pain and factors associated with residual shoulder pain (VAS > 0 at the final follow-up) were analyzed in both groups.
Results
Fifty-two patients were enrolled in the SR group, and 53 were enrolled in the DR group. The DR group appeared to have higher levels of pain 1 week (P < 0.001) and 3 months (P = 0.041) postoperatively, while at other time points, the pain intensity of the two groups was comparable. Fourteen (26.4%) and 25 (48.1%) patients in the DR and the SR groups, respectively, developed residual shoulder pain, (P = 0.022; RR 1.82). The univariate analysis and multiple regression revealed that a poorer quality of tendon tissue is related to residual pain in the SR group, whereas tendon retraction is associated with residual pain in the DR group. The rate of re-tear was similar between the two groups and between patients with and without residual pain.
Conclusions
The DR repair technique results in a greater intensity of pain than that of SR repair during the first 3 months after surgery; however, patients who underwent DR repair presented a significantly lower proportion of residual shoulder pain and better tendon quality after 2 years. Poorer tendon quality and larger tendon retraction as determined intraoperatively were risk factors for residual pain. These results highlight the necessity of promoting healing on the grounds of residual pain prevention.
Level of evidence
II.