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Correlation between Results of Preoperative Impingement Test and Clinical Outcomes after Arthroscopic Rotator Cuff Repair

  • Park, Sung Bae (Department of Orthopedic Surgery, Dankook University Medical College) ;
  • Seo, Joong Bae (Department of Orthopedic Surgery, Dankook University Medical College) ;
  • Ryu, Jee Won (Department of Orthopedic Surgery, Dankook University Medical College) ;
  • Shin, Yong Eun (Department of Orthopedic Surgery, Dankook University Medical College)
  • 투고 : 2017.03.18
  • 심사 : 2017.07.30
  • 발행 : 2017.09.30

초록

Background: The aim of the present study was to determine the correlation between the amount of pain reduction after local anesthetic injection into the subacromial space preoperatively and clinical outcome after arthroscopic rotator cuff repair. Methods: A total of 127 patients who underwent arthroscopic rotator cuff repair and followed up at least 1 year were analyzed retrospectively. Preoperatively, a visual analogue scale (VAS) for pain was measured in all patients before and after the ultrasound guided impingement test. The participants were divied into four groups according to pain reduntion ater impingement test (Group A: >75%, Group B: 50%-75%, Group C: 25%-50%, Group D: <25%). VAS for pain, shoulder range of motion, shoulder isometric strength, ASES score were evaluated preoperatively and at 3, 6, 9, and 12 months postoperatively. Results: After surgery, the amount of pain reduction shows significantly at 3, 6 months in Groups A, B as compared to Groups C, D (p<0.05). Among the range of motion of shoulder joint, forward flexion was significantly improved in Group A at 3 months (p<0.05). The ASES score significantly improved at 3, 6 months in Groups A, B as compared to Group C, D (p<0.05). Conclusions: Preoperative degree of pain reduction after impingement test correlates with the improvement of pain after arthroscopic rotator cuff repair, especially in the early phase. Therefore, the impingement test could be effectively used.

키워드

참고문헌

  1. Mitchell C, Adebajo A, Hay E, Carr A. Shoulder pain: diagnosis and management in primary care. BMJ. 2005;331(7525): 1124-8. https://doi.org/10.1136/bmj.331.7525.1124
  2. Oh LS, Wolf BR, Hall MP, Levy BA, Marx RG. Indications for rotator cuff repair: a systematic review. Clin Orthop Relat Res. 2007;455:52-63. https://doi.org/10.1097/BLO.0b013e31802fc175
  3. Colvin AC, Egorova N, Harrison AK, Moskowitz A, Flatow EL. National trends in rotator cuff repair. J Bone Joint Surg Am. 2012;94(3):227-33. https://doi.org/10.2106/JBJS.J.00739
  4. Judge A, Murphy RJ, Maxwell R, Arden NK, Carr AJ. Temporal trends and geographical variation in the use of subacromial decompression and rotator cuff repair of the shoulder in England. Bone Joint J. 2014;96(1):70-4. https://doi.org/10.2106/JBJS.M.00364
  5. Lee E, Bishop JY, Braman JP, Langford J, Gelber J, Flatow EL. Outcomes after arthroscopic rotator cuff repairs. J Shoulder Elbow Surg. 2007;16(1):1-5. https://doi.org/10.1016/j.jse.2006.04.007
  6. Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am. 2004;86(2):219-24. https://doi.org/10.2106/00004623-200402000-00002
  7. O'Holleran JD, Kocher MS, Horan MP, Briggs KK, Hawkins RJ. Determinants of patient satisfaction with outcome after rotator cuff surgery. J Bone Joint Surg Am. 2005;87(1):121-6. https://doi.org/10.2106/JBJS.C.01316
  8. Oh JH, Kim SH, Kim KH, Oh CH, Gong HS. Modified impingement test can predict the level of pain reduction after rotator cuff repair. Am J Sports Med. 2010;38(7):1383-8. https://doi.org/10.1177/0363546509359071
  9. Neer CS 2nd. Impingement lesions. Clin Orthop Relat Res. 1983;(173):70-7.
  10. Kirkley A, Litchfield RB, Jackowski DM, Lo IK. The use of the impingement test as a predictor of outcome following subacromial decompression for rotator cuff tendinosis. Arthroscopy. 2002;18(1):8-15. https://doi.org/10.1053/jars.2002.29913
  11. Mair SD, Viola RW, Gill TJ, Briggs KK, Hawkins RJ. Can the impingement test predict outcome after arthroscopic subacromial decompression? J Shoulder Elbow Surg. 2004;13(2):150-3. https://doi.org/10.1016/j.jse.2003.12.006
  12. Neer CS 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am. 1972;54(1):41-50. https://doi.org/10.2106/00004623-197254010-00003
  13. Hawkins RJ, Kennedy JC. Impingement syndrome in athletes. Am J Sports Med. 1980;8(3):151-8. https://doi.org/10.1177/036354658000800302
  14. Skedros JG, Pitts TC. Temporal variations in a modified Neer impingement test can confound clinical interpretation. Clin Orthop Relat Res. 2007;460:130-6.
  15. Clarkson HM. Musculoskeletal assessment: joint range of motion and manual muscle strength. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2000.
  16. Richards RR, An KN, Bigliani LU, et al. A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg. 1994;3(6):347-52. https://doi.org/10.1016/S1058-2746(09)80019-0
  17. DeOrio JK, Cofield RH. Results of a second attempt at surgical repair of a failed initial rotator-cuff repair. J Bone Joint Surg Am. 1984;66(4):563-7. https://doi.org/10.2106/00004623-198466040-00011
  18. Altchek DW, Warren RF, Wickiewicz TL, Skyhar MJ, Ortiz G, Schwartz E. Arthroscopic acromioplasty. Technique and results. J Bone Joint Surg Am. 1990;72(8):1198-207. https://doi.org/10.2106/00004623-199072080-00011
  19. Gartsman GM. Arthroscopic acromioplasty for lesions of the rotator cuff. J Bone Joint Surg Am. 1990;72(2):169-80. https://doi.org/10.2106/00004623-199072020-00003
  20. Tetzlaff JE, Brems J, Dilger J. Intraarticular morphine and bupivacaine reduces postoperative pain after rotator cuff repair. Reg Anesth Pain Med. 2000;25(6):611-4. https://doi.org/10.1097/00115550-200011000-00011
  21. Modi CS, Veillette CJ, Gandhi R, Perruccio AV, Rampersaud YR. Factors that influence the choice to undergo surgery for shoulder and elbow conditions. Clin Orthop Relat Res. 2014; 472(3):883-91. https://doi.org/10.1007/s11999-013-3357-0
  22. Oh JH, Kim SH, Ji HM, Jo KH, Bin SW, Gong HS. Prognostic factors affecting anatomic outcome of rotator cuff repair and correlation with functional outcome. Arthroscopy. 2009; 25(1):30-9. https://doi.org/10.1016/j.arthro.2008.08.010
  23. Kang MN, Rizio L, Prybicien M, Middlemas DA, Blacksin MF. The accuracy of subacromial corticosteroid injections: a comparison of multiple methods. J Shoulder Elbow Surg. 2008; 17(1 Suppl):61S-6S. https://doi.org/10.1016/j.jse.2007.07.010
  24. Mathews PV, Glousman RE. Accuracy of subacromial injection: anterolateral versus posterior approach. J Shoulder Elbow Surg. 2005;14(2):145-8. https://doi.org/10.1016/j.jse.2004.06.012
  25. Yamakado K. The targeting accuracy of subacromial injection to the shoulder: an arthrographic evaluation. Arthroscopy. 2002;18(8):887-91. https://doi.org/10.1053/jars.2002.35263