Complications of the Fingers and Hand After Arthroscopic Rotator Cuff Repair

Bentham Science Publishers Ltd. - Tập 12 Số 1 - Trang 134-140 - 2018
Mikio Harada1, Nariyuki Mura2, Masatoshi Takahara1, Michiaki Takagi3
1Department of Orthopedic Surgery, Izumi Orthopedic Hospital, Maruyama Aza Kamiyagari 6-1, Izumi-ku, Sendai, Miyagi, 981-3121, Japan
2Department of Orthopedic Surgery, Yoshioka Hospital, Higashihon-cho 3-5-21, Tendo, Yamagata, 994-0026, Japan
3Department of Orthopedic Surgery, Yamagata University Faculty of Medicine Iida-Nishi-2-2-2, Yamagata, 990-9585, Japan

Tóm tắt

Background: Complications of the fingers and hand that occur after Arthroscopic Rotator Cuff Repair (ARCR) have not been examined in detail. Objective: The aim of our study was to evaluate the diagnosis and treatment of complications of the fingers and hand that occur after ARCR and to examine treatment outcomes. Methods: The case records of 40 patients (41 shoulders) who underwent ARCR using suture anchors were retrospectively reviewed to investigate complications of the fingers and hand after ARCR. Results: Twelve patients (29%) experienced numbness, pain, edema, and movement limitations of the fingers and hand. These symptoms occurred on average 1.1 months (range, 0.1-2.5 months) after ARCR. The diagnoses were cubital tunnel syndrome in 2 hands, carpal tunnel syndrome in 3 hands, and flexor tenosynovitis (TS) in 10 hands. None of the 10 hands with TS exhibited triggering of the fingers. The mean interval between treatment initiation and symptom resolution was 2.2 months for the 5 hands treated by corticosteroid injection or surgery and 5.9 months for the 7 hands treated by alternating warm and cold baths alone. None of the hands exhibited Complex Regional Pain Syndrome (CRPS). Conclusion: Complications of the fingers and hand after ARCR were observed in 29%. TS was the most frequent complication. When symptoms in the fingers and hand occur after ARCR, rather than immediately suspecting CRPS, TS should be primarily suspected, including when TS symptoms such as triggering are not present, and these patients should be treated proactively using corticosteroid injections or surgery.

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Tài liệu tham khảo

Atkins RM. Complex regional pain syndrome. J Bone Joint Surg Br 2003; 85 (8) : 1100-6.

Steinbrocker O, Spitzer N, Friedman HH. The shoulder-hand syndrome in reflex dystrophy of the upper extremity. Ann Intern Med 1948; 29 (1) : 22-52.

Steinbrocker O. The shoulder-hand syndrome: present perspective. Arch Phys Med Rehabil 1968; 49 (7) : 388-95.

Brislin KJ, Field LD, Savoie FH III. Complications after arthroscopic rotator cuff repair. Arthroscopy 2007; 23 (2) : 124-8.

Curtis A, Snyder S, del Pizzo W, et al. Complications of shoulder arthroscopy. Arthroscopy 1992; 8 (3) : 395.

Ishibashi T, Mikasa M, Kumagai H. Reflex sympathetic dystrophy concomitant with rotator cuff tears. Katakansetsu 1993; 17 : 20-3. [Shoulder Joint].

Marecek GS, Saltzman MD. Complications in shoulder arthroscopy. Orthopedics 2010; 33 (7) : 492-7.

Randelli P, Spennacchio P, Ragone V, Arrigoni P, Casella A, Cabitza P. Complications associated with arthroscopic rotator cuff repair: a literature review. Musculoskelet Surg 2012; 96 (1) : 9-16.

Rodeo SA, Forster RA, Weiland AJ. Neurological complications due to arthroscopy. J Bone Joint Surg Am 1993; 75 (6) : 917-26.

Small NC. Complications in arthroscopic surgery performed by experienced arthroscopists. Arthroscopy 1988; 4 (3) : 215-21.

Tachiiri H, Morihara T, Horii M, et al. Changes in the hand after rotator cuff repair - relation with CRPS type I. Katakansetsu 2010; 34 : 495-8. [Shoulder Joint].

Tsukamoto J, Mura N, Goto Y, et al. Reflex sympathetic dystrophy associated with postoperative rotator cuff tears. Rinsho Seikeigeka 2006; 41 : 889-93. [Clinical Orthopaedic Surgery].

Weber SC, Abrams JS, Nottage WM. Complications associated with arthroscopic shoulder surgery. Arthroscopy 2002; 18 (2) (Suppl. 1) : 88-95.

Hanusch BC, Goodchild L, Finn P, Rangan A. Large and massive tears of the rotator cuff: functional outcome and integrity of the repair after a mini-open procedure. J Bone Joint Surg Br 2009; 91 (2) : 201-5.

Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg Am 2005; 87 (6) : 1229-40.

Levy O, Venkateswaran B, Even T, Ravenscroft M, Copeland S. Mid-term clinical and sonographic outcome of arthroscopic repair of the rotator cuff. J Bone Joint Surg Br 2008; 90 (10) : 1341-7.

McBirnie JM, Miniaci A, Miniaci SL. Arthroscopic repair of full-thickness rotator cuff tears using bioabsorbable tacks. Arthroscopy 2005; 21 (12) : 1421-7.

Barber FA, Herbert MA, Click JN. Internal fixation strength of suture anchors--update 1997. Arthroscopy 1997; 13 (3) : 355-62.

Klein AH, France JC, Mutschler TA, Fu FH. Measurement of brachial plexus strain in arthroscopy of the shoulder. Arthroscopy 1987; 3 (1) : 45-52.

Paulos LE, Franklin JL. Arthroscopic shoulder decompression development and application. A five year experience. Am J Sports Med 1990; 18 (3) : 235-44.

Pitman MI, Nainzadeh N, Ergas E, Springer S. The use of somatosensory evoked potentials for detection of neuropraxia during shoulder arthroscopy. Arthroscopy 1988; 4 (4) : 250-5.

Skyhar MJ, Altchek DW, Warren RF, Wickiewicz TL, O’Brien SJ. Shoulder arthroscopy with the patient in the beach-chair position. Arthroscopy 1988; 4 (4) : 256-9.

Koh SM, Moate F, Grinsell D. Co-existing carpal tunnel syndrome in complex regional pain syndrome after hand trauma. J Hand Surg Eur Vol 2010; 35 (3) : 228-31.

Takahara M, Ogino T, Kikuchi N, et al. Various disorders with symptoms and signs similar to complex regional pain syndrome (CRPS) type I. Nihon Tenogeka Zassi 2006; 23 : 581-6. [Japanese Society for Surgery of the Hand].

Harada M, Mura N, Tsuruta D, et al. Complications in arthroscopic rotator cuff repair associated with outcome of the arthroscopic surgery. Katakansetsu 2014; 38 : 912-5. [Shoulder Joint].

Konta M, Harada M, Suzuki T, et al. Complex regional pain syndrome associated with arthroscopic rotator cuff repair. Rinsho Seikeigeka 2015; 50 : 519-22. [Clinical Orthopaedic Surgery].

Berjano P, González BG, Olmedo JF, Perez-España LA, Munilla MG. Complications in arthroscopic shoulder surgery. Arthroscopy 1998; 14 (8) : 785-8.

Andrews JR, Carson WG. Shoulder joint arthroscopy. Orthopedics 1983; 6 (9) : 1157-62.

Stanish WD, Peterson DC. Shoulder arthroscopy and nerve injury: pitfalls and prevention. Arthroscopy 1995; 11 (4) : 458-66.