Associations of mental, social, and pathophysiological factors with pain intensity and capability in patients with shoulder osteoarthritis prior to shoulder arthroplasty: a Dutch Arthroplasty Register Study.

• Tác giả: Niels Brinkman, Melle Broekman, Job Doornberg, Taco Gosens, David Ring, Anneke Spekenbrink-Spooren, Jacob E Thomas, Michel van den Bekerom
• Ngôn ngữ: eng
• Thông tin xuất bản: United States : Journal of shoulder and elbow surgery , 2025
• Bộ sưu tập: NCBI
• ID: 699789

Tóm tắt

 BACKGROUND: Mounting evidence suggests that mental health accounts for greater variation in levels of comfort and capability than pathophysiology severity across a range of musculoskeletal conditions. Using nationwide Dutch Arthroplasty Register (Landelijke Registratie Orthopedische Interventies) data, we tested the null hypothesis that none of the available mental, social, and pathophysiological factors are associated with variation in levels of comfort and capability among people with shoulder osteoarthritis (OA) prior to arthroplasty. METHODS: We included all adult patients who underwent primary total shoulder arthroplasty for OA in the period 2014-2021 with complete measures of shoulder specific capability (Oxford Shoulder Score), pain intensity (10-point Numeric Rating Scale), general wellbeing (the EQ-5D 3-L), the grade of pathophysiology (Walch classification) and categorized social health based on a social deprivation index. In total, 1342 patients with shoulder OA preparing for shoulder arthroplasty were included in a regression analysis to seek factors associated with variation in levels of pain intensity and capability. RESULTS: Greater pain intensity at rest was associated with greater symptoms of anxiety and depression (regression coefficient [RC] = -0.41
  95% confidence interval [CI] = 0.17-0.64
  P <
  .01) and women (RC = 0.38
  95% CI = 0.11-0.66
  P <
  .01). Greater incapability was associated with greater symptoms of anxiety and depression (RC = -3.2
  95% CI = -4.0 to -2.4
  P <
  .01), an American Society of Anesthesiologists score of III and IV (RC = -3.1
  95% CI = -4.8 to -1.4
  P <
  .01), older age (RC = -0.098
  95% CI = -0.15 to -0.047
  P <
 . 01), and women (RC = -3.9
  95% CI = -4.9 to -3.0
  P <
  .01). Neither comfort nor capability were associated with Walch classification or social deprivation index. CONCLUSION: The confirmation that variation in levels of comfort and capability among people preparing for shoulder arthroplasty are associated with mindset rather than a measure of glenoid pathophysiology points to the potential benefits of addressing mental health in musculoskeletal health strategies.