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Neuropathic Pain after Shoulder Arthroplasty : Prevalence, Impact on Physical and Mental Function, and Demographic Determinants

RAZMJOU H; WOODHOUSE LJ; HOLTBY R
PHYSIOTHER CAN , 2018, vol. 70, n° 3, p. 212-220
Doc n°: 188686
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.3138/ptc.2016-99
Descripteurs : AE2 - PARAPLEGIE-TETRAPLEGIE, AD8 - DOULEUR, DD361 - TRAITEMENT CHIRURGICAL - EPAULE

The objectives of this survey study were to provide an estimate of the
prevalence of neuropathic pain (NP) and to explore the cross-sectional and
longitudinal group differences postoperatively.
Method: A cohort of consecutive
patients who had undergone total shoulder arthroplasty (TSA), reverse shoulder
arthroplasty (RSA), or humeral head replacement (HHR) were surveyed within an
average of 3.8 years after surgery. Questionnaires completed at the time of the
survey were the Self-Administered Leeds Assessment of Neuropathic Symptoms and
Signs (S-LANSS) pain scale, the visual analogue scale (VAS) for pain, the Western
Ontario Osteoarthritis of the Shoulder (WOOS) index, the Patient Health
Questionnaire-9 (PHQ-9), and a satisfaction questionnaire. Results: Of the 141
candidates who were invited to participate in the study, 115 patients
participated (85 TSA, 21 HHR, and 9 RSA), for an 82% response rate. Five patients
(4%) met the criteria for NP, of whom one had a loosening of the prosthesis and
required further surgery. Having NP was associated with greater pain (VAS;
p=0.001), greater depression (PHQ-9; p=0.001), more disability (WOOS; p=0.030),
and less satisfaction with the surgery (p=0.014). There was no relationship
between the presence of NP and patients' age, sex, preoperative pain, range of
motion results,
or WOOS scores (p>0.05).
Conclusions: Persistent pain of
neuropathic origin is not common after shoulder arthroplasty, but it is a
significant contributor to poor mental and physical well-being and thus warrants
further research.

Langue : ANGLAIS

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