Factors Related to Pain in Patients With Retorn Rotator Cuffs: Early Postoperative Pain Predicts Pain at 12 Months Postoperatively

Abstract

Background: Retearing of a repaired rotator cuff leads to diverse symptoms, including pain, regardless of the degree of the tear, but the relationship between pain and retears is poorly understood. Purpose: To determine which factors are correlated with shoulder pain in retears of a repaired rotator cuff. Study Design: Case-control study; Level of evidence, 3. Methods: We retrospectively reviewed a cohort of patients who were diagnosed as having a retear on magnetic resonance imaging after primary rotator cuff repair. The primary outcome variable of interest was the visual analog scale (VAS) for pain score at 12-month and final follow-up (mean, 25.2 months). We evaluated the relationship of pain at 12-month and final follow-up with preoperative patient factors (age, sex, and underlying conditions), preoperative range of motion, and preoperative pain; postoperative pain at 3 and 6 months; and perioperative conditions (tear extent, tear size, accompanying lesions, and procedures other than rotator cuff repair). Results: A total of 48 patients were reviewed. The VAS score at 3 months postoperatively showed a positive correlation with the VAS score at 12 months postoperatively (ρ = 0.537; P < .001) and at final follow-up (ρ = 0.537; P < .001). Univariate and multivariate regression analyses revealed that the VAS score at 3 months postoperatively ( P = .0001 and P = .0017, respectively), hypertension ( P = .0108 and P = .0073, respectively), and late detection of the retear ( P = .0091 and P = .0208, respectively) were significant predictors of pain at 12 months postoperatively. Conclusion: The presence of pain in the early postoperative period, underlying hypertension, and late detection of the retear were related to pain severity in patients 12 months after rotator cuff surgery.