Risk Factors for postoperative shoulder pain of acromioclavicular joint dislocation treat with hook plate

Abstract Background: Postoperative shoulder pain was a most common complication after clavicular hook plate treatment for acromioclavicular joint dislocation. However, the researches on its risk factors were rare. The purpose of this study was to evaluate the incidences of postoperative shoulder pain of acromioclavicular joint dislocation treat with hook plate and to identify risk factors in patients with an acute acromioclavicular joint dislocation. Method: We retrospectively analyzed the prospectively collected data from 310 consecutive patients with AC joint dislocation between December 2014 and August 2019 at our institute. Patients rated the average intensity of shoulder pain using an 11-point numerical rating scale (NRS). The dependent variable was the presence of moderate-to-severe neck pain (NRS ≥4) at the last follow-up when the internal fixation will be removed. The independent variables included age, gender, body-mass index (BMI), smoking status, alcohol consumption, type of injury, Rockwood Classification, site of injury, operation time, injury-to-surgery, DHA, DH and AHP. Logistic regression analysis was performed to identify independent risk factors of moderate-to-severe shoulder pain of acromioclavicular joint dislocation treat with hook plate. Results: A total of 292 patients were included in the study and 18 cases were lost to follow-up. The follow-up rate was 94.1%. In all cases, there were 166 male cases and 126 female cases. Of these cases, the NRS < 4 group had 219 patients. Among them, there were 120 males and 99 females. 12 patients were lost to follow-up. There were 73 patients in NRS ≥ 4 group, 46 males and 27 females. 6 cases were lost to follow-up. The number of patient in NRS ≥ 4 group accounted for about 25.0% of the total cases. DH was the significant independent risk factor for postoperative shoulder pain of acromioclavicular joint dislocation treat with hook plate. DHA and AHP were also independent factors of postoperative shoulder pain, but they were all protective. Conclusions: DH was the significant independent risk factor for postoperative shoulder pain of acromioclavicular joint dislocation treat with hook plate. DHA and AHP were also independent factors of postoperative shoulder pain, but they were all protective. We should try to refer to these factors to avoid postoperative shoulder pain when performing clinical operations.