Article

Shoulder pain and surgery are common among older adults. However, the
extent to which older age affects recovery after shoulder surgery is not well
understood. OBJECTIVE: To assess influence of older age on postoperative recovery
factors 3 and 6 months after shoulder arthroscopy. DESIGN: Prospective cohort
study. SETTING: University-affiliated outpatient orthopedic surgical center.
PATIENTS: A convenience sample of 139 persons between 20 and 79 years of age who
experienced shoulder pain, had musculoskeletal dysfunction based on imaging and
physician assessment, and were scheduled for an arthroscopic shoulder procedure.
MAIN OUTCOME MEASURES: Postoperative outcomes were compared among younger,
middle-aged, and older adults before surgery and at 3 and 6 months after surgery
using analysis of variance modeling. Movement-evoked pain and an experimental
laboratory correlate of pain processing were assessed at each time point. The
influence of older age on 3- and 6-month pain outcomes were determined via
multivariate regression analyses after accounting for preoperative,
intraoperative, and postoperative prognostic factors. RESULTS: Older adults had
higher movement-evoked pain intensity (F2,108 = 5.18, P = .007) and experimental
pain response (F2,111 = 7.24, P = .001) at 3 months compared with young and
middle-aged adults. After controlling for key prognostic factors, older age
remained a positive predictor of 3-month movement-evoked pain (R(2) = 0.05;
standardized [St.] beta = 0.263, P = .031) and experimental pain response (R(2) =
0.07; St. beta = 0.295, P = .014). Further, older age remained a positive
predictor of movement-evoked pain at 6 months (R(2) = 0.04; St. beta = 0.231, P =
.004), despite no age group differences in outcome. Older age was found to be the
strongest predictor of 3- and 6-month movement-evoked pain. CONCLUSION: Older
adults may experience more pain related to movement, as well as endogenous pain
excitation, in the first few months after shoulder arthroscopy. Future
age-related research should consider use of movement-evoked pain intensity and
experimental pain response as pain outcomes, as well as the utility of such
measures in clinical care.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS