Distal Mononeuropathy Before and After Arthroscopic Rotator Cuff Repair: A Prospective Investigation.
Publication/Presentation Date
4-1-2018
Abstract
PURPOSE: The purpose of this study was to characterize the occurrence of distal mononeuropathy (DMN) in patients before and after arthroscopic rotator cuff repair (RCR) as well as resolution of the symptoms.
METHODS: One hundred one patients over the age of 18 undergoing arthroscopic RCR +/- concurrent procedures completed a questionnaire regarding the presence of a symptomatic DMN. Patients with history of diabetic neuropathy, cervical radiculopathy, brachial plexopathy, or Spurling sign were excluded. All patients underwent physical examination to determine the characteristics and location of symptoms. Postoperatively, patients underwent repeat examination at 2, 6, and 12 weeks.
RESULTS: Preoperatively, 19% (19/101) of RCR patients described DMN symptoms (9 median nerve symptoms, 5 ulnar nerve symptoms, 4 nonspecific symptoms, one with both ulnar and median nerve symptoms). Ninety percent (17/19) patients with preoperative DMN symptoms described resolution within the final 12 weeks of follow-up. A portion of previously asymptomatic RCR patients (12/82) developed new DMN symptoms (6 nonspecific symptoms, 3 ulnar nerve symptoms, 2 median nerve symptoms, one radial sensory nerve symptoms) postoperatively, with 92% (11/12) having resolution by the final 12-week follow-up. At the final 12 weeks, 3 RCR patients had DMN symptoms with 2 of those 3 patients having their symptoms existing preoperatively.
CONCLUSIONS: This study supports the hypothesis that DMN can be a preexisting finding in patients undergoing arthroscopic RCR. Similarly, it is common for patients undergoing arthroscopic RCR to develop new DMN symptoms following their procedure. Regardless, there is good evidence to show that a large majority of both groups of patients will go on to have resolution of their symptoms.
LEVEL OF EVIDENCE: Level IV, prospective case series.
Volume
34
Issue
4
First Page
1186
Last Page
1191
ISSN
1526-3231
Published In/Presented At
Horneff, J. G., 3rd, Pepe, M., Tucker, B., Tjoumakaris, F., Lombardi, N., Wowkanech, C., & Austin, L. S. (2018). Distal Mononeuropathy Before and After Arthroscopic Rotator Cuff Repair: A Prospective Investigation. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 34(4), 1186–1191. https://doi.org/10.1016/j.arthro.2017.10.046
Disciplines
Medicine and Health Sciences
PubMedID
29361423
Department(s)
Department of Emergency Medicine, Fellows and Residents
Document Type
Article