title: Postoperative pain after arthroscopic versus open rotator cuff repair. A prospective study.
abstract: BACKGROUND
  Although the arthroscopic technique is becoming the gold standard for rotator cuff tendon repair, there is no proof that this technique results in less postoperative pain compared to open repair. The aim of this study was to prospectively compare the postoperative pain level after arthroscopic or open rotator cuff repair and to define factors that could influence its course.
  
  
  METHODS
  Between January 2012 and January 2013, 95 patients were operated for a rotator cuff tear: 45 using an arthroscopic technique and 50 an open technique. Daily analgesic use and self-evaluation of pain level using a visual analogic scale were recorded preoperatively and twice a day postoperatively during the first 6 weeks. These data were compared between the two groups and analyzed according to patients' demographic data and preoperative evaluation of the tear.
  
  
  RESULTS
  The preoperative pain level was equivalent in the two groups (P=0.22). Postoperatively, level-2 analgesic medication use was greater in the arthroscopic group after the 4th week (P=0.01). A pain-free shoulder was obtained before the 6th week in 75% and 66% of the patients after arthroscopic or open repair, respectively (P=0.34). There was a positive correlation between the preoperative and postoperative pain level (r=0.25; P=0.02). Work compensation patients experienced more pain postoperatively (P=0.08). Level-III analgesic medication use was greater for patients with massive rotator cuff tear (P=0.001).
  
  
  CONCLUSIONS
  No evidence was found on the superiority of arthroscopy versus open repair of rotator cuff tear concerning the postoperative pain level. The choice of the surgical technique should not be based on this argument.
  
  
  METHODS
  II.
authors.affiliation: Institut de l'appareil locomoteur, hôpital Pierre-Paul-Riquet, place du Docteur-Baylac, 31059 Toulouse, France. Electronic address: francethuytrang@yahoo.fr.
authors.forename: T T
authors.initials: TT
authors.lastname: Pham
authors.affiliation: Institut de l'appareil locomoteur, hôpital Pierre-Paul-Riquet, place du Docteur-Baylac, 31059 Toulouse, France.
authors.forename: X
authors.initials: X
authors.lastname: Bayle Iniguez
authors.affiliation: Institut de l'appareil locomoteur, hôpital Pierre-Paul-Riquet, place du Docteur-Baylac, 31059 Toulouse, France.
authors.forename: P
authors.initials: P
authors.lastname: Mansat
authors.affiliation: EA CNRS 6296, IAE de Tours, université François-Rabelais, 37200 Tours, France.
authors.forename: L
authors.initials: L
authors.lastname: Maubisson
authors.affiliation: Institut de l'appareil locomoteur, hôpital Pierre-Paul-Riquet, place du Docteur-Baylac, 31059 Toulouse, France.
authors.forename: N
authors.initials: N
authors.lastname: Bonnevialle
mesh_terms: D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000009:adverse effects*; D001182:Arthroscopy / Q000009:adverse effects*; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D010149:Postoperative Pain / Q000175:diagnosis* / Q000209:etiology; D011446:Prospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture; D016896:Treatment Outcome
keywords: Arthroscopic; Open; Postoperative pain; Rotator cuff repair