Development of a clinical prediction model for chronic post-surgical shoulder pain following arthroscopic rotator cuff repair: A prospective cohort study

Background: In patients with symptomatic rotator cuff tears, arthroscopic rotator cuff repair (ARCR) is typically recommended when conservative management fails to provide symptom relief. Chronic post-surgical pain (CPSP) following ARCR is not uncommon and significantly reduces function and quality of life. This study aimed to develop a clinical prediction model for CPSP after ARCR. Methods: This prospective analysis included 103 participants who underwent ARCR between August 2022 and November 2024. Potential predictor outcome variables were recorded preoperatively, and postoperative pain was assessed at 6 weeks, 3 months, and 6 months. The primary outcome was CPSP at rest and on shoulder movements, which was measured at the 6-month follow-up. Results: Prediction models were developed using binomial logistic regression analysis and bootstrapping techniques for internal validation. Key independent predictors included scores on measures of Pain Catastrophizing Scale, Depression, Anxiety, Stress Scale 21, and Central Sensitization Inventory, as well as the pressure pain threshold over the middle deltoid muscle on the affected side. Conclusion: Prediction models have been developed to forecast the occurrence of CPSP of the shoulder at 6 months post-ARCR. This represents a foundational step towards providing tailored risk evaluation, which can guide decisions regarding surgical management and therapeutic interventions for patients undergoing ARCR.