Anxiety and depression predict poor outcomes in arthroscopic subacromial decompression

Dekker, Andrew P.; Salar, Omer; Karuppiah, S. V.; Bayley, Edward; Kurian, Jomy

doi:10.1016/j.jse.2016.01.031

Cited by 40 publications

(35 citation statements)

References 24 publications

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“… 20 36–44 46–50 High levels of resilience 47 and preoperative expectations 20 46 were significantly associated with low levels of pain intensity. High levels of depressive symptoms, 37 41 43 48 49 anxiety, 41 43 50 pain catastrophising, 36 37 emotional distress 43 and somatisation 43 were significantly associated with high levels of pain intensity. There was no statistical relationship between sleep disturbances, fear of pain, kinesiophobia and pain intensity in people with CSP presurgery and postsurgery.…”

Section: Resultsmentioning

confidence: 96%

The role of psychological factors in the perpetuation of pain intensity and disability in people with chronic shoulder pain: a systematic review

et al. 2018

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IntroductionChronic shoulder pain is a very complex syndrome, and the mechanisms involved in its perpetuation remain unclear. Psychological factors appear to play a role in the perpetuation of symptoms in people with shoulder chronicity. The purpose of this systematic review is to examine the role of psychological factors in the perpetuation of symptoms (pain intensity and disability) in people with chronic shoulder pain.Methods and analysisA systematic search was performed on PubMed, AMED, CINAHL, PubPsych and EMBASE from inception to July 2017. Longitudinal studies with quantitative designs analysing the role of psychological factors on pain intensity, disability or both were included. The methodological quality of the included studies was evaluated with an adapted version of the Newcastle Ottawa Scale. The level of evidence per outcome was examined using the Grading of Recommendations Assessment, Development and Evaluation approach.ResultsA total of 27 articles were included with a sample of 11 176 people with chronic shoulder pain. The risk of bias ranges from 7/21 to 13/21 across the studies. The quality of the evidence was very low. High levels of self-efficacy, resilience and expectations of recovery were significantly associated with low levels of pain intensity and disability. Inversely, high levels of emotional distress, depressive symptoms, anxiety, preoperative concerns, fear-avoidance beliefs, somatisation and pain catastrophising were significantly associated with high levels of pain intensity and disability.DiscussionOur results suggest that psychological factors may influence the perpetuation of pain intensity and disability, with very low evidence. A meta-analysis was not carried out due to the heterogeneity of the included studies so results should be interpreted with caution.PROSPERO trial registration numberCRD42016036366.

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Section: Resultsmentioning

confidence: 96%

The role of psychological factors in the perpetuation of pain intensity and disability in people with chronic shoulder pain: a systematic review

et al. 2018

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“…Previous literature has consistently shown that patients with active depression or anxiety have higher levels of pain, greater expectations, and poorer outcomes than those who do not. 35 36 37 38 Interpretation of these results is difficult. It may be that some patients are more aware of their retained implants.…”

Section: Discussionmentioning

confidence: 99%

Improvement in Functional Outcomes After Elective Symptomatic Orthopaedic Implant Removal

et al. 2020

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Introduction: The relative indications for removing symptomatic implants after osseous healing are not fully agreed on. The purpose of this study was to (1) determine whether patients showed improvement in functional outcomes after the removal of symptomatic orthopaedic implants, (2) compare the outcomes between upper and lower extremity implant removal, and (3) determine the rate of implant removal complications. Methods: A prospective study was conducted between 2013 and 2016. Patients completed a Short Musculoskeletal Function Assessment outcome questionnaire before implant removal and at the 6-month follow-up. Demographic data were stratified and compared between upper and lower extremity groups and between preimplant removal and 6-month postremoval. Results: Of the 119 patients included in the study, 85 (71.4%) were lower extremity and 34 (28.6%) were upper extremity. Significant improvement after implant removal was seen in the dysfunction index ( P ≤ 0.001), bother index ( P ≤ 0.001), and daily activities domain ( P ≤ 0.001). Depression or anxiety ( P = 0.016) were statistically significant predictors for an improved Short Musculoskeletal Function Assessment dysfunction index score at 6 months. The complication rate was 10.1% (n=12) for the cohort. Discussion: Implant removal in both the upper and lower extremity presented notable improvement in dysfunction. Complications that require surgical intervention are extremely rare.

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“…We expected to find an association between psychological vulnerability parameters (HADS, PCS and STAI) and unexplained persistent pain, however, except for the association between unexplained persistent pain and high t-STAI score, present results found no associations between unexplained persistent pain and psychological vulnerability parameters. These findings are in contrast with a retrospective ASD study where an association between persistent pain and depression was found [8]. A prospective study with recordings of patients’ vulnerability both before and after surgery is needed.…”

Section: Discussionmentioning

confidence: 64%

High prevalence of persistent pain 6 months after arthroscopic subacromial decompression and/or acromioclavicular joint resection

Brix

Thillemann

Bjørnholdt

et al. 2019

SICOT-J

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Purpose: The aims of this prospective study were to determine the prevalence of pain 6 months after arthroscopic subacromial decompression (ASD) and/or acromioclavicular joint resection (AC resection), to reveal causes of the pain, and to identify risk factors for persistent pain. Methods: Preoperatively, patients were tested for their endogenous capacity to modulate pain and completed questionnaires concerning psychological vulnerability. Patients with pain 6 months after surgery were examined by an experienced orthopaedic surgeon to reveal any shoulder pathology responsible for the pain. Results: Data from 101 patients were available for analysis 6 months after surgery. Thirty-six patients had persistent pain: 32 underwent examination by the surgeon who identified shoulder pathology in ten patients, but not in the remaining 22 in whom ongoing insurance case, unemployment, and a general tendency to worry were risk factors for persistent pain. Conclusion: The prevalence of persistent pain 6 months after ASD and/or AC resection was 35.6% (95% CI 26.1–45.8%) and the proportion of patients with shoulder pathology was 9.9%. An association between ongoing insurance case, unemployment, general tendency to worry (t-STAI), and unexplained persistent pain 6 months after surgery was found.

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Anxiety and depression predict poor outcomes in arthroscopic subacromial decompression

Cited by 40 publications

References 24 publications

The role of psychological factors in the perpetuation of pain intensity and disability in people with chronic shoulder pain: a systematic review

The role of psychological factors in the perpetuation of pain intensity and disability in people with chronic shoulder pain: a systematic review

Improvement in Functional Outcomes After Elective Symptomatic Orthopaedic Implant Removal

High prevalence of persistent pain 6 months after arthroscopic subacromial decompression and/or acromioclavicular joint resection

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