From the Guidelines
Patient satisfaction rates after rotator cuff repair surgery are generally high, with approximately 85-95% of patients reporting good to excellent outcomes, and pain scores typically show significant improvement from pre-operative levels. Pain management after rotator cuff repair surgery is crucial for improving patient outcomes. The following key points are essential for managing pain and improving satisfaction rates:
- Pre-operative and intra-operative interventions that improve postoperative pain include paracetamol, cyclo-oxygenase-2 inhibitors, intravenous dexamethasone, regional analgesia techniques, and arthroscopic surgical technique 1.
- The analgesic regimen for rotator cuff repair should include an arthroscopic approach, paracetamol, non-steroidal anti-inflammatory drugs, dexamethasone, and a regional analgesic technique, with opioids as rescue analgesics 1.
- Suprascapular nerve block reduces pain scores and/or opioid use after surgery but does not seem to have analgesic advantages over interscalene block 1.
- Factors affecting satisfaction and pain outcomes include tear size, tissue quality, patient age, compliance with rehabilitation protocols, and pre-existing conditions.
- Patients should maintain realistic expectations about recovery timeframes, as complete pain resolution may take several months to a year.
- A multimodal approach to pain management, including acetaminophen, NSAIDs, and short-term opioids, can help manage discomfort and improve patient outcomes 1. Some interventions, such as subacromial injection or infusion, stellate ganglion block, and cervical epidural block, are not recommended due to inconsistent or limited evidence 1. Overall, a well-planned pain management strategy can significantly improve patient satisfaction rates and reduce pain scores after rotator cuff repair surgery.
From the Research
Satisfaction Rates after Rotator Cuff Repair Surgeries
- Satisfaction rates after rotator cuff repair surgeries are generally high, with one study finding that 95% of patients were satisfied with the outcome of the surgery 2.
- Another study found that satisfaction with surgery was >96% at all time points, with the plateau of maximum recovery for pain, function, and motion occurring at 1 year 3.
- A study on patients with rotator cuff retear found that 78% of patients were satisfied with the outcome of the surgery, with satisfaction correlated with postoperative American Shoulder and Elbow Surgeon (ASES) score and visual analog scale (VAS) pain level 4.
Pain Scores after Rotator Cuff Repair Surgeries
- Pain scores after rotator cuff repair surgeries have been found to decrease significantly over time, with one study finding that approximately 75% of pain relief can be expected at 3 months after surgery 3.
- Another study found that the worst pain with movement 0 to 48 hours after block placement was lower in patients who received a comprehensive enhanced recovery pathway, with a mean difference of -2.7 [95% CI -3.7 to -1.7] 5.
- A study on patient understanding, expectations, and satisfaction regarding rotator cuff injuries and surgical management found that patient education preoperatively regarding details about the surgery and the postoperative plan is critical in helping set patients' preoperative expectations, which can affect pain scores and satisfaction 6.
Factors Influencing Satisfaction and Pain Scores
- Factors that influence satisfaction and pain scores after rotator cuff repair surgeries include improvement in functional outcomes and general health status, married and employed status, and high preoperative and postoperative met expectations 2, 3.
- Tear size and type can also influence satisfaction and pain scores, with larger tears having a slower speed of recovery and lower satisfaction rates 3, 4.
- Patient education and understanding of the surgery and postoperative plan can also affect satisfaction and pain scores, with evidence supporting that postoperative patient satisfaction is highly influenced by preoperative patient expectations 6.