Imai Takaki, Gotoh Masafumi, Fukuda Keiji, Ogino Misa, Nakamura Hidehiro, Ohzono Hiroki, Shiba Naoto, Okawa Takahiro
Department of Rehabilitation, Kyushu University of Nursing and Social Welfare, Kumamoto, Japan.
Department of Orthopedic Surgery, Kurume University Medical Center, Fukuoka, Japan.
Clin Shoulder Elb. 2021 Jun;24(2):80-87. doi: 10.5397/cise.2021.00080. Epub 2021 May 18.
Complex regional pain syndrome (CRPS)-related hand lesions are one of the complications following arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the clinical outcomes of patients with CRPS-related hand lesions following ARCR.
Altogether, 103 patients with ARCR were included in this study (mean age, 63.6±8.2 years; 66 males and 37 females; follow-up period, preoperative to 12 months postoperative). Clinical assessment included the Japanese Orthopaedic Association (JOA) score, University of California, Los Angeles (UCLA) score, Constant score, 36-item short form health survey (SF-36) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score from preoperative to 12 months postoperatively. The patients were either assigned to the CRPS group or non-CRPS group depending on CRPS diagnosis until the final follow-up, and clinical outcomes were then compared between the groups.
Of 103 patients, 20 (19.4%) had CRPS-related hand lesions that developed entirely within 2 months postoperatively. Both groups showed significant improvement in JOA, UCLA, and Constant scores preoperatively to 12 months postoperatively (P<0.001). Comparisons between the two groups were not significantly different, except for SF-36 "general health perception" (P<0.05) at 12 months postoperatively. At final follow-up, three patients had residual CRPS-related hand lesions with limited range of motion and finger edema.
CRPS-related hand lesions developed in 19.4% of patients following ARCR. Shoulder or upper-limb function improved in most cases at 12 months, with satisfactory SF-36 patient-based evaluation results. Patients with residual CRPS-related hand lesions at the last follow-up require long-term follow-up.
复杂区域疼痛综合征（CRPS）相关的手部病变是关节镜下肩袖修复术（ARCR）后的并发症之一。本研究旨在调查ARCR术后发生CRPS相关手部病变患者的临床结局。
本研究共纳入103例ARCR患者（平均年龄63.6±8.2岁；男66例，女37例；随访期为术前至术后12个月）。临床评估包括术前至术后12个月的日本骨科协会（JOA）评分、加利福尼亚大学洛杉矶分校（UCLA）评分、Constant评分、36项简明健康调查（SF-36）评分以及手臂、肩部和手部快速残疾评定量表（QuickDASH）评分。根据CRPS诊断将患者分为CRPS组或非CRPS组，直至最终随访，然后比较两组的临床结局。
103例患者中，20例（19.4%）出现CRPS相关的手部病变，均在术后2个月内完全出现。两组患者术前至术后12个月的JOA、UCLA和Constant评分均有显著改善（P<0.001）。两组间比较，除术后12个月的SF-36“总体健康感知”（P<0.05）外，差异均无统计学意义。在最终随访时，3例患者残留CRPS相关的手部病变，活动范围受限且手指水肿。
ARCR术后19.4%的患者出现CRPS相关的手部病变。大多数患者在术后12个月时肩部或上肢功能改善，基于患者的SF-36评估结果令人满意。最后随访时残留CRPS相关手部病变的患者需要长期随访。
