Abstract
Objectives:
To determine if patients who have undergone prior open or arthroscopic shoulder surgery and develop distal mononeuropathy (DMN) achieve the same clinical benefit after nerve release compared to those who did not have a prior shoulder procedure; via level III symptom prevalence retrospective matched cohort study.
Methods:
Patients were identified by CPT code for shoulder arthroplasty, shoulder stabilization, and rotator cuff repair and if they had an ensuing nerve release (cubital or carpal tunnel) within 2 years of shoulder surgery. Another cohort who underwent nerve release surgery for DMN with no prior history of shoulder surgery was identified and subsequently matched to the first cohort by 3:1 (control: case) ratio. Patients were included if they were over the age of 18. Chart review and surveys stored using REDCapTM (Vanderbilt, Nashville TN) were used to collect demographics, surgical history, electromyography/nerve conduction velocity (EMG/NCV) results, post-operative symptoms, and patient-reported outcomes with minimum 2-year follow-up.
Results:
In total, 120 patients were included in this analysis (28 cases, 92 controls). The most common nerve release for DMN across both cohorts was open carpal tunnel release. Following nerve release, the case group had more postoperative persistent numbness/tingling than the control group. Both groups were equivalent with regard to postoperative pain, weakness, or standardized outcome measures (ASES, SANE, DASH). Residual postoperative numbness following nerve release was more likely to occur in the forearm for the case group than the control group.
Conclusions:
Patients with a history of arthroscopic rotator cuff repair and reverse total shoulder replacement shoulder surgery before the presentation of DMN are more likely to experience persistent numbness or tingling after nerve release surgery as well as experience symptoms in the forearm than those without prior shoulder surgery.
