The investigation of risk factors for onset and severity of crps type 1 after arthroscopic rotator cuff repair

Abstract

14 THE INVESTIGATION OF RISK FACTORS FOR ONSET AND SEVERITY OF CRPS TYPE 1 AFTER ARTHROSCOPIC ROTATOR CUFF REPAIR Kou Hidani, Mitsuru Nagoshi, Tadashi Miyamoto, Numakuma Hospital, Nagoshi Orthopedic Clinic, Fukuyama Medical Center Objective: There are few reports about CRPS after ARCR, although we sometimes experience it due to the severe pain and rigid sling fixation after operation. In this study we researched about which factors correlated with CRPS after ARCR. Subject & method: Japanese Minister of Health’s Criterion was adopted as a diagnosis of CRPS.We defined the patients who had after effects of CRPS even after half a year after treatment, as resistant CRPS group. Subjects of the present study were 288 shoulders of 256 patients who attended our departments between January 2012 and December 2014. Risk factors analyzed for CRPS were age, gender, dominant side, insurance, diabetes, the period suffering shoulder pain before ARCR, tear size, suture method, sling size, JOA score and shoulder contracture. Patients with CRPS were treated with oral steroids and warm and cool contrast bath therapy. Statistical analysis was carried out with multivariate analysis. Result: CRPS rate after ARCR was 7.3 % (21/288), resistant CRPS rate was 42.9% (9/21). Diabetes and contracture were correlated to CRPS, being male and ulnar nerve palsy were significantly related to resistant CRPS. Consideration: Our CRPS rate was lower compared with other papers so far.We suppose that this result was caused by our early short term therapeutic intervention even when only symptoms come down without objective signs. Also, from our results, it may be suggested that once CRPS is diagnosed, more careful observation and treatment are needed for male patients and those with ulnar nerve palsy to prevent severe after effects like finger contracture.