Hagedorn Jonathan M, Pittelkow Thomas P, Bendel Markus A, Moeschler Susan M, Orhurhu Vwaire, Sanchez-Sotelo Joaquin
Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic, Rochester, MN, USA.
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
JSES Rev Rep Tech. 2022 May 30;2(3):269-276. doi: 10.1016/j.xrrt.2022.04.008. eCollection 2022 Aug.
Shoulder arthroplasty is a successful surgical procedure for several conditions when patients become refractory to conservative management modalities. Unfortunately, some patients experience persistent chronic pain after shoulder arthroplasty. These individuals should undergo a comprehensive evaluation by an orthopedic surgeon to determine whether structural pathology is responsible for the pain and to decide whether reoperation is indicated. At times, a surgical solution does not exist. In these circumstances, a thorough and specific plan for the management of persistent chronic pain should be developed and instituted. In this article, we review common reasons for persistent pain after shoulder arthroplasty and outline the evaluation of the painful shoulder arthroplasty. We then provide a thorough review of interventional pain management strategies. Finally, we hypothesize developments in our field that might provide better outcomes in the future for patients suffering with chronic intractable pain after shoulder arthroplasty.
当患者对保守治疗方式无效时，肩关节置换术对于多种病症来说是一种成功的外科手术。不幸的是，一些患者在肩关节置换术后会经历持续的慢性疼痛。这些患者应由骨科医生进行全面评估，以确定疼痛是否由结构病变引起，并决定是否需要再次手术。有时，不存在手术解决方案。在这种情况下，应制定并实施针对持续性慢性疼痛的全面且具体的管理计划。在本文中，我们回顾了肩关节置换术后持续疼痛的常见原因，并概述了对疼痛性肩关节置换术的评估。然后，我们对介入性疼痛管理策略进行了全面回顾。最后，我们推测本领域的发展可能会为肩关节置换术后患有慢性顽固性疼痛的患者在未来带来更好的治疗效果。
