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

Anupama Prabhu Bailoor; Gundmi Arun Maiya; Vivek Pandey; Kiran Kv Acharya; Jagannath Vennila; James Elliott Matthew; Mira Meeus

doi:10.1177/17585732251415002

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

Shoulder Elbow. 2026 Jan 27:17585732251415002. doi: 10.1177/17585732251415002. Online ahead of print.

Authors

Anupama Prabhu Bailoor¹, Gundmi Arun Maiya¹, Vivek Pandey², Kiran Kv Acharya², Jagannath Vennila³, James Elliott Matthew^{4

5}, Mira Meeus^{6

7}

Affiliations

¹ Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
² Department of Orthopaedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
³ Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
⁴ The Kolling Institute, Northern Sydney (Arabanoo) Precinct, St Leonards, Australia.
⁵ Sydney School of Health Sciences, The University of Sydney, Camperdown, Australia.
⁶ MOVANT Research Group, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Antwerp, Belgium.
⁷ Pain in Motion, University of Antwerp, Antwerp, Belgium.

Abstract

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.

Keywords: Chronic pain; prospective study; risk factors; rotator cuff repair.