1. Is distal peripheral neuropathy common after shoulder arthroplasty?
- Author
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Allison J. Rao, Ian S. MacLean, Kassandra N. Blanchard, Gregory P. Nicholson, and Amanda J. Naylor
- Subjects
medicine.medical_specialty ,business.industry ,Incidence (epidemiology) ,medicine.medical_treatment ,medicine.disease ,Arthroplasty ,Surgery ,medicine.anatomical_structure ,Peripheral neuropathy ,Medicine ,Orthopedics and Sports Medicine ,Patient-reported outcome ,business ,Carpal tunnel syndrome ,Range of motion ,Crush syndrome ,Cubital tunnel - Abstract
Background Neurologic injury after shoulder arthroplasty has been reported in previous outcome studies. However, the incidence and development of distal peripheral neuropathy (DPN) after shoulder arthroplasty requiring surgical intervention has not been previously described. Hypothesis The authors report on the incidence of DPN requiring surgical intervention following shoulder arthroplasty. Methods A retrospective review was conducted of a prospectively collected shoulder arthroplasty registry at a single institution from a single surgeon from April 2006 to April 2017. Patients were included in the series if they had primary surgical intervention for ipsilateral or contralateral peripheral neuropathy following primary shoulder arthroplasty. Patients were excluded if they had known peripheral neuropathy or cervical radiculopathy prior to surgery. DPN was defined for the study as symptoms or diagnostic testing consistent with cubital tunnel or carpal tunnel syndrome. Demographics, patient reported outcome measures, and preoperative and postoperative shoulder range of motion were collected and analyzed with paired t-tests and multivariate regression models. Results One thousand three hundred eighty-seven total shoulder arthroplasties were performed in this period. During the study period, 16 patients (1.2%) underwent surgery for ipsilateral DPN while 6 patients (0.4%) underwent surgery for contralateral DPN. ASES scores, SANE scores, and shoulder flexion improved significantly from pre- to postoperatively for both groups. There was no significant difference in postoperative scores between groups. Finally, the multivariate linear analysis did not yield any statistically significant regression equations for ASES, SANE VAS, AFE, and AER. Conclusion Shoulder arthroplasty resulted in increased ipsilateral distal peripheral neuropathy. Emergence of DPN symptoms following arthroplasty is multifactorial and may be related to a form of the double crush syndrome. Level of evidence Level IV; Case series
- Published
- 2021
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