title: Persistent pain is common 1-2 years after shoulder replacement.
abstract: OBJECTIVE
  Persistent postsurgical pain is a well-recognized problem after various types of surgery such as amputation and thoracotomy. The prevalence of persistent pain, and the extent to which it involves neuropathic pain, is highly dependent on the type of surgery. We investigated the prevalence of, characteristics of, and risk factors for persistent pain 1-2 years after shoulder replacement.
  
  
  METHODS
  A questionnaire was sent to patients who underwent primary shoulder replacement between April 2011 and April 2012, and whose data were recorded in the Danish Shoulder Arthroplasty Register. Patients who had undergone reoperation or bilateral replacements were excluded. Persistent pain was defined as constant or daily pain within the last month, which interfered much or very much with daily activities. Multivariate logistic regression was used to assess risk factors.
  
  
  RESULTS
  538 patients were available for analysis. The prevalence of persistent pain was 22% (CI: 18-25), and the prevalence of presumed neuropathic pain was 13% (CI: 10-16). Persistent pain was more frequent in fracture patients (29%) than in osteoarthritis patients (16%), while the prevalence of neuropathic pain was similar. Severe pain during the first postoperative week increased the risk of persistent pain. Risk also increased with hemiprosthesis (as compared to total prosthesis) in osteoarthritis patients, and with previous osteosynthesis and pain elsewhere in fracture patients.
  
  
  CONCLUSIONS
  Persistent pain after shoulder replacement is a daily burden for many patients. Further studies should address patient and prosthesis selection, postoperative pain management, and follow-up of these patients.
authors.affiliation: Department of Orthopedic Surgery, Horsens Hospital.
authors.forename: Karen T
authors.initials: KT
authors.lastname: Bjørnholdt
authors.forename: Birgitte
authors.initials: B
authors.lastname: Brandsborg
authors.forename: Kjeld
authors.initials: K
authors.lastname: Søballe
authors.forename: Lone
authors.initials: L
authors.lastname: Nikolajsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000379:methods*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009437:Neuralgia / Q000453:epidemiology*; D010003:Osteoarthritis / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology*; D012042:Registries; D012784:Shoulder Fractures / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*; D020069:Shoulder Pain / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult