Martel Marie, Laumonerie Pierre, Pecourneau Virginie, Ancelin David, Mansat Pierre, Bonnevialle Nicolas
Centre Hospitalier Universitaire de Toulouse, Hôpital Pierre Paul Riquet, Place Baylac, 31059 Toulouse cedex 09, France.
Indian J Orthop. 2020 Jun 13;54(Suppl 1):210-215. doi: 10.1007/s43465-020-00174-8. eCollection 2020 Sep.
Complex Regional Pain Syndrome type 1 (CRPS1) is a potential complication, affecting the prognosis of functional joint recovery. Its incidence ranges from 2 to 40% depending on the series and the joints involved. Very few studies have evaluated the incidence of CRPS after shoulder surgery. The objective of our study was to determine the incidence of CRPS1 and to identify any pre-operative risk factors associated with its emergence after extra-articular subacromial space surgery.
This is a retrospective single-centre study of patients who underwent surgery for a subacromial extra-articular shoulder pathology from January 2016 to December 2016 and included a follow-up period of at least 6 months. The primary inclusion criterion was developing a CRPS1 as defined by Veldman. A pre- and post-operative clinical assessment was performed based on the Constant (Cst) score.
Among the 287 patients, with an average follow-up period of 6.5 months, included in the study, 38 (13%) presented with post-operative CRPS1. Treated hypothyroidism (OR = 3.79; 95% CI 1.58;9.07; = 0.003), open surgery (OR = 2.92; 95% CI 1.35-6.32; = 0.007) and the level of daily physical activity from the Cst score (OR = 0.088; 95% CI 0.79;0.97; = 0.015) were found to be significantly associated with the onset of CRPS1.
CRPS1 affected more than 10% of patients who underwent surgery for a subacromial shoulder pathology. The current study identified hypothyroidism, open surgery, and pre-operative clinical status as risk factors for the onset of this complication. These parameters should, therefore, be taken into consideration during the patient's pre-operative consultation.
1型复杂性区域疼痛综合征（CRPS1）是一种潜在并发症，会影响关节功能恢复的预后。其发病率因研究系列和受累关节的不同，在2%至40%之间。很少有研究评估肩部手术后CRPS的发病率。我们研究的目的是确定CRPS1的发病率，并识别关节外肩峰下间隙手术后出现CRPS1的术前风险因素。
这是一项对2016年1月至2016年12月因肩峰下关节外肩部病变接受手术且随访期至少6个月的患者进行的回顾性单中心研究。主要纳入标准是出现符合Veldman定义的CRPS1。基于Constant（Cst）评分进行术前和术后临床评估。
在纳入研究的287例患者中，平均随访期为6.5个月，38例（13%）出现术后CRPS1。治疗过的甲状腺功能减退症（OR = 3.79；95% CI 1.58；9.07；P = 0.003）、开放手术（OR = 2.92；95% CI 1.35 - 6.32；P = 0.007）以及Cst评分中的日常身体活动水平（OR = 0.088；95% CI 0.79；0.97；P = 0.015）被发现与CRPS1的发生显著相关。
CRPS1影响了超过10%因肩峰下肩部病变接受手术的患者。本研究确定甲状腺功能减退症、开放手术和术前临床状态是该并发症发生的风险因素。因此，在患者术前咨询期间应考虑这些参数。
