Table 3.
Pain reporting, functional scores and range of motion.
| Study | Year | Functional assessment scores | Baseline ROM (active or passive) | ROM (active or passive) scores at final follow up | Functional scores (pre-op) | Functional scores (post-op) |
|---|---|---|---|---|---|---|
| Morris et al. | 2015 | Constant score, the American Shoulder and Elbow Surgeons (ASES) score, the Western Ontario Osteoarthritis Shoulder (WOOS) index, the Single Assessment Numeric Evaluation (SANE), and range of motion measurements. | Preoperative opioid group: Forward flexion 40 ± 37; Abduction 38 ± 36; External rotation 8 ± 16. Non opioid group: Forward flexion 43 ± 51; Abduction 42 ± 49; External rotation 9 ± 13. | Pre-oprative opioid group: Forward flexion 142 ± 30; Abduction 136 ± 39; External rotation 32 ± 16. Non opioid group: Forward flexion 147 ± 29; Abduction 145 ± 30; External rotation 27 ± 16. | Pre-oprative opioid group: total Constant score 14.9 ± 8.7; ASES 25.6 ± 13.1; WOOS 79.0 ± 14.0; SANE; 27.9 ± 26.4. Non opioid group: total Constant score 19.4 ± 13.3; ASES 37.4 ± 18.6; WOOS 67.4 ± 20.2; SANE; 27.9 ± 24.8. | Pre-oprative opioid group: total Constant score 58.8 ± 19.5; ASES 65.0 ± 26.4; WOOS 33.4 ± 31.6; SANE; 62.8 ± 32.9. Non opioid group: total Constant score 67.4 ± 18.5; ASES 75.8 ± 21.4; WOOS 22.3 ± 21.1; SANE; 62.1 ± 35.8 |
| Morris et al. | 2016 | Constant score, the American Shoulder and Elbow Surgeons (ASES) score, the Western Ontario Osteoarthritis Shoulder (WOOS) index, the Single Assessment Numeric Evaluation (SANE), and range of motion measurements. | Preoperative opioid group: Forward flexion 73 ± 39; Abduction 70 ± 39; External rotation 11 ± 14. Non opioid group: Forward flexion 89 ± 37; Abduction 82 ± 36; External rotation 11 ± 15. | Pre-oprative opioid group: Forward flexion 155 ± 32; Abduction 153 ± 32; External rotation 45 ± 13. Non opioid group: Forward flexion 164 ± 13; Abduction 164 ± 14; External rotation 46 ± 13. | Pre-oprative opioid group: total Constant score 21 ± 16; ASES 33 ± 19; WOOS 76 ± 13; SANE 32 ± 28. Non opioid group: total Constant score 32 ± 17; ASES 44 ± 18; WOOS 62 ± 18; SANE 32 ± 24. | Pre-oprative opioid group: total Constant score 73 ± 20; ASES 83 ± 20; WOOS 19 ± 25; SANE 67 ± 35. Non opioid group: total Constant score 82 ± 12; ASES 89 ± 15; WOOS 11 ± 16; SANE 71 ± 36. |
| Cuff et al. | 2016 | VAS | NR | NR | NR | NR |
| Cheah et al. | 2017 | VAS, ASES | NR | NR | VAS pain scores between groups were similar, with a trend of higher scores in long-acting opioid users; ASES shoulder scores between groups were similar, with a trend of higher scores in opioid users. | VAS pain scores were higher in opioid users (4.0 ± 1.8 for nonusers, 4.9 ± 1.9 for short-acting users, and 6.0 ± 1.5 for long-acting users; P < 0.001); ASES scores: Analysis of variance showed similar preoperative and 2-year postoperative ASES results between both non–opioid users and opioid users in the TSA and rTSA groups. |
| Berglund et al. | 2018 | NR | NR | NR | NR | NR |
| Grace et al. | 2018 | VAS and ASES score | NR | NR | Opioid users reported worse pain (7 vs 4, P = 0.007) and ASES (32.8 vs 46.0, P = 0.003) scores in the preoperative period compared with non-opioid users. | Opioid users again reported more pain in the operative shoulder than non-opioid users 6 weeks after surgery (1 vs 0, P = 0.036), the magnitude of improvement from the preoperative visit to 6 weeks after surgery was similar between the 2 cohorts (4 vs 3, P = 0.16). Both the 6-week postoperative ASES scores (51.6 vs 56.2, P = 0.32) and the magnitude of ASES score improvement from preoperatively to 6 weeks postoperatively (18.8 vs 10.2, P = 0.11) were similar between the 2 groups. |
| Menendez et al. | 2018 | Preoperative ASES score | NR | NR | 34.1 ± 16.5 | NR |
| Rao et al. | 2018 | NR | NR | NR | NR | NR |
| Thompson et al. | 2019 | ASES scores, VAS scores, ROM, strength | Preoperative opioid group: FE ROM 90 (130; 20 to 150), strength 4 (2; 3 to 5); ER ROM 30 (90; −10 to 80), strength 5 (1; 4 to 5); IR ROM 30 (85; 0 to 85), strength 5 (1; 4 to 5). Non opioid group: FE ROM 110 (170; 0 to 170), strength 5 (3; 2 to 5); ER ROM 30 (80; 0 to 80), strength 5 (2; 3 to 5); IR ROM 45 (120; 0 to 120), strength 5 (1; 4 to 5). | Preoperative opioid group: FE ROM 135 (130; 50 to 180), strength 5 (2; 3 to 5); ER ROM 45 (60;0 to 60), strength 5 (1; 4 to 5); IR ROM 60 (150; 0 to 150), strength 5 (1; 4 to 5). Non opioid group: FE ROM 160 (185; 85 to 270), strength 5 (1; 4 to 5); ER ROM 45 (60; 25 to 85), strength 5 (0; 4 to 5); IR ROM 60 (60; 30 to 90), strength 5 (0; 4 to 5). | Preoperative opioid group: ASES 32 (61; 0 to 61); VAS 6 (8; 2 to 10). Non opioid group: ASES 42 (75; 5 to 80); VAS 5 (9; 1 to 10). | Preoperative opioid group: ASES 61 (96; 0 to 96); VAS 2 (10; 2 to 10). Non opioid group: ASES 91.7 (43.4; 56.6 to 100); VAS 0 (3; 0 to 3). |
| Brock et al. | 2019 | NR | NR | NR | NR | NR |
| Curtis et al. | 2019 | Numeric Rating Scale (NRS) | NR | NR | Scores were not significantly different between cohorts. NRS at rest: (F = 1.26; P = 0.26). NRS with activity: (F = 0.01; P = 0.93). | Postoperatively, the opioid cohort demonstrated mean resting pain score of 3.0 6 2.6, which was 1.6 points higher than that of the nonopioid cohort, 1.4 6 1.9 (P < 0.001). |
| Mayer et al. | 2019 | VAS | NR | NR | No other significant differences in preop VAS between both groups (7.0 vs 6.0 P = 0.10) | At 2 wk postoperatively, there was no statistically significant difference in VAS scores between chronic preoperative narcotic users and nonusers, although there was a trend toward higher VAS scores among narcotic users. At 6 and 12 wk, however, chronic narcotic users had significantly higher VAS scores. |
| Williams et al. | 2019 | ASES, SST, VAS and ROM | Preoperative opioid group: Forward flexion 120 ± 36; Abduction 110 ± 37; External rotation (side) 56 ± 18; External rotation (90) 74 ± 18. Non opioid group: Forward flexion 134 ± 31; Abduction 126 ± 34; External rotation (side) 63 ± 14; External rotation (90) 78 ± 15. | Preoperative opioid group: Forward flexion 147 ± 22; Abduction 148 ± 19; External rotation (side) 65 ± 15; External rotation (90) 83 ± 15. Non opioid group: Forward flexion 153 ± 13; Abduction 151 ± 15; External rotation (side) 67 ± 8; External rotation (90) 83 ± 11. | Pre-oprative opioid group: total Constant score 48.3 ± 15.6; ASES 32.1 ± 16.1; SST 4.1 ± 2.5; VAS 6.7 ± 2.2. Non opioid group: total Constant score 60.1 ± 17.4; ASES 47.6 ± 19.6; SST 6.1 ± 3.3; VAS 4.9 ± 2.6. | Pre-oprative opioid group: total Constant score 81.3 ± 14.1; ASES 68.4 ± 27.8; SST 7.5 ± 3.7; VAS 3.2 ± 3.0. Non opioid group: total Constant score 60.1 ± 17.4; ASES 47.6 ± 19.6; SST 6.1 ± 3.3; VAS 4.9 ± 2.6. |
| Khazi et al. | 2019 | NR | NR | NR | NR | NR |
| Kolade et al. | 2020 | NR | NR | NR | NR | NR |
| Best et al. | 2020 | NR | NR | NR | NR | NR |
| Sabesan et al. | 2020 | NR | NR | NR | NR | NR |
| Jildeh et al. | 2020 | NR | NR | NR | NR | NR |
| Peratikos et al. | 2020 | NR | NR | NR | NR | NR |
| Lu et al. | 2020 | American Shoulder and Elbow Surgeo), SANE, Constant score, SF-12 MCS, SF-12 PCS, pain VAS, VR-12 MCS, VR-12 PCS, and Veterans RAND 6D | NR | NR | American Shoulder and Elbow Surgeon form (36.6 ± 16.8 vs 46.5 ± 17.5), SANE (25.10 ± 19.05 vs 32.64 ± 19.01), Constant–Murley score (10.9 ± 5.34 vs 12.5 ± 4.99), SF-12 MCS (51.1 ± 12.0 vs 55.2 ± 8.74), SF-12 PCS (31.1 ± 5.21 vs 35.5 ± 7.03), pain VAS (6.23 ± 1.91 vs 5.06 ± 2.13), VR-12 MCS (52.6 ± 11.2 vs 57.7 ± 8.32), VR-12 PCS (33.5 ± 5.7 vs 38.1 ± 7.46), and Veterans RAND 6D (59 ± 8 vs 65 ± 8), for the OU and NOU cohorts, respectively | Both the OU and NOU groups showed statistically significant improvement—at the P < 0.05 level—in all PROMs after shoulder surgery; however, the OU group had significantly worse absolute outcome scores on all PROM measures compared with the NOU group (all P < 0.001) |
| Farley et al. | 2020 | NR | NR | NR | NR | NR |