What Are the Risk Factors for Shoulder, Elbow Surgery?

Patients with functional somatic syndromes such as fibromyalgia, irritable bowel syndrome, chronic headaches and chronic low back pain are more likely to experience poorer outcomes, higher opioid usage, and cost after shoulder and elbow surgery, according to new study.

The findings of “Patients with Functional Somatic Syndromes – Fibromyalgia, Irritable Bowel Syndrome, Chronic Headaches and Chronic Low Back Pain – Have Lower Outcomes And Higher Opioid Usage And Cost After Shoulder and Elbow Surgery,” were published online on December 30, 2022 in the journal Arthroscopy.

In their study, the researchers conducted a systematic review to better understand the relationship between functional somatic syndromes and patient-reported outcome measures, post-operative opioid consumption, and hospitalization costs after shoulder and elbow surgery. They only included studies that evaluated the effect of having at least one functional somatic syndrome (fibromyalgia, irritable bowel syndrome, chronic headaches, and chronic low back pain). The researchers focused on comparing postoperative analgesic use, patient-reported outcome measures and hospitalization costs.

Eight studies with 57,389 patients met the inclusion criteria. Three of the studies reported patient-reported outcomes and the data suggests that having at least one functional somatic syndrome increases a patient’s risk of higher pain scores and lower quality of recovery.

Seven of the studies had data on postoperative opioid use. Five of the seven found that a diagnosis of at least one functional somatic syndrome was a strong risk factor for long-term opioid use after surgery. One of the studies with 480 patients also reported that time-drive activity-based costs were higher in patients with functional somatic syndromes.

“While patient-reported outcomes among patients with functional somatic syndromes are inferior compared to those without functional somatic syndromes, patient-reported outcome measures still improve compared to baseline,” the researchers wrote.

Study authors include Raisa Masood, M.S., Krishna Mandalia, B.S., Michael A. Moverman, M.D., Richard N. Puzzitiello, M.D., Nicholas R. Pagani, M.D., Mariano E. Menendez, M.D. and Matthew J. Salzler, M.D., of Tufts Medical Center in Boston, Massachusetts.