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Shoulder Arthritis / Rotator Cuff Tears: causes of shoulder pain: Return to comfortable sleep after rotator cuff repair

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These authors observe that “Because sleep disturbances from pain are a primary driver for patients with rotator cuff tears to see a physician, one of the main goals of rotator cuff repair (RCR) surgery is to eliminate night-time pain and restore normal sleep patterns in these patients.”  They sought to determine the percentage of patients undergoing arthroscopic rotator cuff repair (RCR) who reported preoperative sleep disturbances and how their sleep disturbance resolved over time after repair surgery. 

In their evaluation, they used question 2 of the Shoulder test (SST): “does your shoulder allow you to sleep comfortably?” 

291 patients (89%) reported preoperative sleep disturbances. Patients with workers’ compensation cases were significantly more likely to report sleep disturbances; all 34 patients who had workers’ compensation cases reported preoperative sleep disturbances compared with 88% of patients without workers’ compensation cases. Additionally, the pretreatment mean VAS pain score was significantly higher in the group that reported sleep disturbances. No other significant differences were detected between groups. Notably, their study showed no statistically significant relationship between rotator cuff tear size or patient demographics. In addition, this study showed that postoperatively, there was no statistically significant relationship between rotator cuff tear size and the resolution of sleep disturbances,

Of those with preoperative sleep disturbance, 19% failed to resolve their sleep disturbance. Within the cohort of patients who reported resolution of sleep disturbances, 46% reported resolution by 3 months postoperatively; an additional 31%, by 6 months; a further 14%, by 12 months; and the final 8%, by 24 months. 


Of those 35 patients without preoperative sleep disturbance, 12 had sleep disturbance at 3 months, 2 at 6 months and 1 at 24 months.

Comment: This study demonstrates the utility of analyzing the 12 specific functions assessed by the Simple Shoulder Test.

Most shoulder evaluation systems in common use (Constant, ASES, SAS, PROMIS, SANE, etc) present the result as a single numerical score which may carry little meaning to the average patient.  By contrast, the Simple Shoulder Test presents data on the postoperative improvement in individual shoulder functions in a way that is easily understood as shown in the example below showing the patient reported outcomes for scapulothoracic fusion. Patients come to surgery desiring to improve their lost comfort and function, not to get a higher “score” on some outcome measure.


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