The Effect of Co-Morbidity on Pain, Function and General Health Status After Rotator Cuff Repair

Authors: Robert Tashjian, MD Cumberland RI

References: AAOS 2005

Abstract
Medical co-morbidities have a negative effect on improvement in pain, shoulder function and general health after chronic rotator cuff repair.

Medical co-morbidities have a negative effect on preoperative pain, function and general health status in patients with chronic rotator cuff tears. In this study, we evaluated the relationship between medical co-morbidities and the postoperative outcome of rotator cuff repair.

125 patients with chronic rotator cuff tears were evaluated with a history (including medical co-morbidities) and outcome tools preoperatively and at 1 year postoperatively after rotator cuff repair. Outcome was evaluated with the DASH, SST, visual analog scales (pain, function and quality of life), and the SF-36. Statistical analysis was performed with a stepwise multivariate regression analysis.

The mean number of co-morbidities was 1.91 (range 0 to 6). A greater number of co-morbidities was associated with worse improvement from preoperative pain (pain VAS [p=0.009]), function (function VAS [p=0.022], DASH [p=0.044]), and general health (quality of life VAS [p=0.041]). In addition, a greater number of co-morbidities was associated with worse postoperative general health status (SF36 physical function [p=0.05], SF36 bodily pain [p=0.032], SF36 general health [p<0.001], SF36 vitality [p=0.033]).

Patients with increased numbers of medical co-morbidities appear to have less improvement in their shoulder pain, function and general health status as a result of rotator cuff repair. This information may be useful when selecting treatment and predicting the outcome for individual patients.

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