These authors assessed the predictors of pain and functional outcomes in a longitudinal cohort of 50 patients undergoing operative treatment for rotator cuff tears from March 2011 to January 2015. Patients completed Shoulder Pain and Disability Index (SPADI) questionnaires at 3, 6, 12, and 18 months.
They found that lower Fear-Avoidance Beliefs Questionnaire physical activity score (P = .001) predicted a lower SPADI score (better shoulder pain and function). Those consuming alcohol 1 to 2 times per week or more had lower SPADI scores than those consuming alcohol 2 to 3 times per month or less (P = .017).
Variables that were not significant predictors of SPADI included sociodemographic characteristics, preoperative magnetic resonance imaging characteristics, such as tear size and muscle quality, shoulder strength, and variations in surgical techniques (single row, double row, transosseous equivalent, performance of biceps surgery).
Comment: The design of this study is curious. In that the goal of cuff repair is to restore the integrity of the cuff tendons to the tuberosity, it would have seemed essential to assess the integrity of the repair at followup among the "comprehensive set of potential" "predictors of pain and functional outcomes" after surgery.
The association of greater alcohol consumption with less self-assessed pain and functional limitation does not seem to support the concept that those consuming more alcohol are better candidates for surgery (as the article seems to suggest).
A few other questions come up:
is the SPADI in common enough use in cuff surgery to enable comparison of the results with other studies?
is the Fear-Avoidance Beliefs Questionnaire physical activity score a common and comparable instrument for assessing physical activity (better than the SF36, for example).
Does this article indeed help us predict the pain and functional outcomes after operative treatment for rotator cuff tears?
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