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Critical Reviews™ in Physical and Rehabilitation Medicine
SJR: 0.121 SNIP: 0.228 CiteScore™: 0.17

ISSN Imprimer: 0896-2960
ISSN En ligne: 2162-6553

Critical Reviews™ in Physical and Rehabilitation Medicine

DOI: 10.1615/CritRevPhysRehabilMed.2016016230
pages 159-170

Acute Postoperative Pain Is a Predictor of Chronic Functional Impairment 2 Years After Radial Head Arthroplasty

Manraj Nirmal Kaur
Surgical Outcomes Research Center (SOURCE), Department of Surgery, McMaster University, Hamilton, Ontario, Canada; School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
Joy C. MacDermid
School of Rehabilitation Sciences, McMaster University, 1400 Main Street West, Hamilton, Ontario, Canada, L8S1C7
Ruby Grewal
Roth McFarlane Hand and Upper Limb Centre, University of Western Ontario, Ontario, Canada
Paul Stratford
School of Rehabilitation Sciences, Faculty of Health Sciences, Department of Surgery, McMaster University, Ontario, Canada
Graham King
Roth McFarlane Hand and Upper Limb Centre, University of Western Ontario, Ontario, Canada

RÉSUMÉ

Background. The aim of this prospective cohort study was to assess whether a relationship exists between acute postoperative pain after radial head arthroplasty (RHAP) and chronic functional impairment (CFI) 2 years after surgery. Methods. A total of 59 patients who underwent RHAP for acute radial head fractures were included in the study. Pain subscale of the condition-specific American Shoulder and Elbow Evaluation Instrument (ASES-e) and the region-specific Disability of Arm, Shoulder and Hand (DASH) questionnaire at baseline (within 3 days of surgery) and at the 2-year follow-up were used to assess the relationship between acute postsurgical pain and CFI 2 years after RHAP. Stepwise regression modeling was used. Results. Higher baseline ASES-e pain subscale significantly improved the predictive ability of the regression model, accounting for 24.4% of variation. Patients with a score of 31.5/50 on the ASES-e pain subscale were four times more likely to experience reduced functional outcomes as indicated by their DASH score (≥20/100). Discussion. Acute postoperative pain predicts CFI at the 2-year follow-up after RHAP. Future multicenter prospective trials with large sample size are required to test the validity of the predictive model and cutoff score.


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