Exploring the Impact of Arthroscopic Surgery on Sleep Quality and Clinical Recovery in Chronic Lateral Epicondylitis Patients
Öz
Abstract
Aim: The purpose of the current study was to investigate the postoperative pattern of sleep quality and to evaluate the correlation between sleep quality and clinical scores in patients following arthroscopic surgery for chronic persistent lateral epicondylitis (ASCPLE).
Methods: The current study included consecutive patients seeking lateral epicondylitis (LE) treatment at four orthopaedic outpatient clinics between 2020 and 2022 who failed to improve with conservative treatments and consented to ASCPLE. The current study evaluated patient demographics, the Pittsburgh Sleep Quality Index (PSQI), and patient-rated outcomes measures (PROMs) like the Disability of the Arm, Shoulder, and Hand (DASH) score and the Patient-rated Tennis Elbow Evaluation (PRTEE) score before and after ASCPLE surgery, with follow-up assessments at three weeks, three months, and six months.
Results: The study involved 28 patients aged 32-47 years. Statistically significant decreases were observed in the PSQI and DASH values at postoperative 3rd week, 3rd month, and 6th month compared to preoperative values (p<0.05). The PRTEE scoring showed a decrease in postoperative period and an increase in postoperative 6th month, albeit statistically lower than preoperative period. The present investigation revealed a significant correlation between preoperative PSQI scores and DASH and PRTEE scores, with a correlation of 71.9% and 67.3%, respectively.
Conclusion: ASCPLE significantly improves sleep quality and reduces clinical scores up to six months postoperatively, but caution is needed due to the potential risk of symptom recurrence and deteriorating sleep quality over time.
Anahtar Kelimeler
Etik Beyan
This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Fırat University (Approval Date: 27/09/2023, Approval Number: 2023/13-44). Written informed consent was obtained from all participants, thereby ensuring their voluntary participation and authorization for the utilization of their anonymized data in the current study publication.
Destekleyen Kurum
No funding
Kaynakça
- 1. Pierce, T. P., Issa, K., Gilbert, B. T., Hanly, B., Festa, A., McInerney, V. K, et al. A Systematic Review of Tennis Elbow Surgery: Open Versus Arthroscopic Versus Percutaneous Release of the Common Extensor Origin. Arthroscopy. 2017;33(6):1260-8.
- 2. RRiff AJ, Saltzman BM, Cvetanovich G, Frank JM, Hemu MR, Wysocki RW. Open vs Percutaneous vs Arthroscopic Surgical Treatment of Lateral Epicondylitis: An Updated Systematic Review. Am J Orthop (Belle Mead NJ). 2018;47(6).
- 3. Brummel J, Baker CL 3rd, Hopkins R, Baker CL Jr. Epicondylitis: lateral. Sports Med Arthrosc Rev. 2014;22(3):e1-e6.
- 4. Kim GM, Yoo SJ, Choi S, Park YG. Current Trends for Treating Lateral Epicondylitis. Clin Shoulder Elb. 2019;22(4):227-34.
- 5. Clark T, McRae S, Leiter J, Zhang Y, Dubberley J, MacDonald P. Arthroscopic Versus Open Lateral Release for the Treatment of Lateral Epicondylitis: A Prospective Randomized Controlled Trial. Arthroscopy. 2018;34(12):3177-84.
- 6. Solheim E, Hegna J, Øyen J. Arthroscopic versus open tennis elbow release: 3- to 6-year results of a case-control series of 305 elbows. Arthroscopy. 2013;29(5):854-9.
- 7. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10(4):287-333.
- 8. Bjurstrom MF, Irwin MR. Polysomnographic characteristics in nonmalignant chronic pain populations: A review of controlled studies. Sleep Med Rev. 2016;26:74-86.
- 9. Gustorff B, Dorner T, Likar R, Grisold W, Lawrence K, Schwarz F, et al. Prevalence of self-reported neuropathic pain and impact on quality of life: a prospective representative survey. Acta Anaesthesiol Scand. 2008;52(1):132-6.
- 10. Smith MT, Haythornthwaite JA. How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature. Sleep Med Rev. 2004;8(2):119-32.
- 11. Sağlam G, Aküzüm F, Çetinkaya Alişar D. Assessment of psychiatric disorders and sleep quality in chronic lateral epicondylitis. Kronik lateral epikondilitte psikiyatrik bozuklukların ve uyku kalitesinin değerlendirilmesi. Agri. 2022;34(3):193-9.
- 12. Sampaio RA, Sewo Sampaio PY, Yamada M, Tsuboyama T, Arai H. Self-reported quality of sleep is associated with bodily pain, vitality and cognitive impairment in Japanese older adults. Geriatr Gerontol Int. 2014;14(3):628-35.
- 13. Altan L, Ercan I, Konur S. Reliability and validity of Turkish version of the patient rated tennis elbow evaluation. Rheumatol Int. 2010;30(8):1049-54.
- 14. Rompe JD, Overend TJ, MacDermid JC. Validation of the Patient-rated Tennis Elbow Evaluation Questionnaire. J Hand Ther. 2007;20(1):3-11.
- 15. Ikpeze TC, Smith HC, Lee DJ, Elfar JC. Distal Radius Fracture Outcomes and Rehabilitation. Geriatr Orthop Surg Rehabil. 2016;7(4):202-5.
- 16. Yalin M, Golgelioglu F, Key S. The ageless approach: Nonoperative mastery competes head-on with surgery for elderly distal radius fractures. J Orthop Res. 2024;42(1):141-7.
- 17. Ha E, Lho YM, Seo HJ, Cho CH. Melatonin Plays a Role as a Mediator of Nocturnal Pain in Patients with Shoulder Disorders. J Bone Joint Surg Am. 2014;2;96(13):e108.
- 18. Mulligan EP, Brunette M, Shirley Z, Khazzam M. Sleep quality and nocturnal pain in patients with shoulder disorders. J Shoulder Elbow Surg. 2015;24(9):1452-7.
- 19. da Luz DC, de Borba Y, Ravanello EM, Daitx RB, Döhnert MB. Iontophoresis in lateral epicondylitis: a randomized, double-blind clinical trial. J Shoulder Elbow Surg. 2019;28(9):1743-9.
- 20. Austin L, Pepe M, Tucker B, Ong A, Nugent R, Eck B, et al. Sleep disturbance associated with rotator cuff tear: correction with arthroscopic rotator cuff repair. Am J Sports Med. 2015;43(6):1455- 9.
- 21. Serbest S, Tiftikçi U, Askın A, Yaman F, Alpua M. Preoperative and post-operative sleep quality evaluation in rotator cuff tear patients. Knee Surg Sports Traumatol Arthrosc. 2017;25(7):2109-13.
- 22. Horneff JG 3rd, Tjoumakaris F, Wowkanech C, Pepe M, Tucker B, Austin L. Long-term Correction in Sleep Disturbance Is Sustained After Arthroscopic Rotator Cuff Repair. Am J Sports Med. 2017;45(7):1670- 5.
- 23. Minns Lowe CJ, Moser J, Barker K. Living with a symptomatic rotator cuff tear 'bad days, bad nights': a qualitative study. BMC Musculoskelet Disord. 2014;15:228.
- 24. Herquelot E, Bodin J, Roquelaure Y, Ha C, Leclerc A, Goldberg M, et al. Work-related risk factors for lateral epicondylitis and other cause of elbow pain in the working population. Am J Ind Med. 2013;56(4):400-9.
- 25. Savoie FH 3rd, O'Brien MJ. Arthroscopic tennis elbow release. Instr Course Lect. 2015;64:225-30.
- 26. Babaqi AA, Kotb MM, Said HG, AbdelHamid MM, ElKady HA, ElAssal MA. Short-term evaluation of arthroscopic management of tennis elbow; including resection of radio-capitellar capsular complex. J Orthop. 2014;11(2):82-6.
- 27. Behazin M, Kachooei AR. Arthroscopic Recession Technique in the Surgery of Tennis Elbow by Sharp Cutting the Extensor Carpi Radialis Brevis (ECRB) Tendon Origin. Arch Bone Jt Surg. 2021;9(2):174-9.
- 28. Evans JP, Porter I, Gangannagaripalli JB, Bramwell C, Davey A, Smith CD, et al. Assessing Patient-Centred Outcomes in Lateral Elbow Tendinopathy: A Systematic Review and Standardised Comparison of English Language Clinical Rating Systems. Sports Med Open. 2019;5(1):10.
- 29. Barandiaran AF, Houck DA, Schumacher AN, Seidl AJ, Frank RM, Vidal AF, et al. Shoulder Surgery as an Effective Treatment for Shoulder-Related Sleep Disturbance: A Systematic Review. Arthroscopy. 2022;38(3):989-1000.e1.
Kronik Lateral Epikondilit Hastalarında Artroskopik Cerrahinin Uyku Kalitesi ve Klinik İyileşme Üzerindeki Etkisinin Araştırılması
Öz
Özet
Amaç: Bu çalışmanın amacı kronik persistan lateral epikondilit (ASCPLE) nedeniyle artroskopik cerrahi uygulanan hastalarda ameliyat sonrası uyku kalitesi paternini araştırmak ve uyku kalitesi ile klinik skorlar arasındaki korelasyonu değerlendirmektir.
Yöntemler: Bu çalışmaya 2020-2022 yılları arasında dört ortopedi polikliniğinde lateral epikondilit (LE) tedavisi gören, konservatif tedavilerle iyileşme sağlanamayan ve ASCPLE'ye onay veren ardışık hastalar dahil edildi. Bu çalışmada, ASCPLE ameliyatı öncesinde ve sonrasında hasta demografisi, Pittsburgh Uyku Kalitesi İndeksi (PSQI) ve Kol, Omuz ve El Engelliliği (DASH) skoru ve Hasta Tarafından Değerlendirilen Tenisçi Dirseği Değerlendirmesi (PRTEE) skoru gibi hasta tarafından değerlendirilen sonuç ölçümleri (PROM'lar) üç hafta, üç ay ve altı aylık takip değerlendirmeleriyle değerlendirilmiştir.
Sonuçlar: Çalışmaya yaşları 32-47 arasında değişen 28 hasta dahil edildi. Postoperatif 3. hafta, 3. ay ve 6. ayda PSQI ve DASH değerlerinde preoperatif değerlere göre istatistiksel olarak anlamlı düşüşler gözlendi (p<0.05). PRTEE skorlamasında ameliyat öncesi döneme göre istatistiksel olarak daha düşük olmakla birlikte ameliyat sonrası dönemde azalma, ameliyat sonrası 6. ayda ise artış görüldü. Bu araştırma, ameliyat öncesi PSQI skorları ile DASH ve PRTEE skorları arasında sırasıyla %71.9 ve %67.3'lük bir korelasyon ile anlamlı bir ilişki olduğunu ortaya koymuştur.
Sonuç: ASCPLE, ameliyat sonrası altı aya kadar uyku kalitesini önemli ölçüde iyileştirmekte ve klinik skorları azaltmaktadır, ancak semptomların nüksetmesi ve zaman içinde uyku kalitesinin bozulması riski nedeniyle dikkatli olunması gerekmektedir.
Anahtar Kelimeler
Kaynakça
- 1. Pierce, T. P., Issa, K., Gilbert, B. T., Hanly, B., Festa, A., McInerney, V. K, et al. A Systematic Review of Tennis Elbow Surgery: Open Versus Arthroscopic Versus Percutaneous Release of the Common Extensor Origin. Arthroscopy. 2017;33(6):1260-8.
- 2. RRiff AJ, Saltzman BM, Cvetanovich G, Frank JM, Hemu MR, Wysocki RW. Open vs Percutaneous vs Arthroscopic Surgical Treatment of Lateral Epicondylitis: An Updated Systematic Review. Am J Orthop (Belle Mead NJ). 2018;47(6).
- 3. Brummel J, Baker CL 3rd, Hopkins R, Baker CL Jr. Epicondylitis: lateral. Sports Med Arthrosc Rev. 2014;22(3):e1-e6.
- 4. Kim GM, Yoo SJ, Choi S, Park YG. Current Trends for Treating Lateral Epicondylitis. Clin Shoulder Elb. 2019;22(4):227-34.
- 5. Clark T, McRae S, Leiter J, Zhang Y, Dubberley J, MacDonald P. Arthroscopic Versus Open Lateral Release for the Treatment of Lateral Epicondylitis: A Prospective Randomized Controlled Trial. Arthroscopy. 2018;34(12):3177-84.
- 6. Solheim E, Hegna J, Øyen J. Arthroscopic versus open tennis elbow release: 3- to 6-year results of a case-control series of 305 elbows. Arthroscopy. 2013;29(5):854-9.
- 7. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10(4):287-333.
- 8. Bjurstrom MF, Irwin MR. Polysomnographic characteristics in nonmalignant chronic pain populations: A review of controlled studies. Sleep Med Rev. 2016;26:74-86.
- 9. Gustorff B, Dorner T, Likar R, Grisold W, Lawrence K, Schwarz F, et al. Prevalence of self-reported neuropathic pain and impact on quality of life: a prospective representative survey. Acta Anaesthesiol Scand. 2008;52(1):132-6.
- 10. Smith MT, Haythornthwaite JA. How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature. Sleep Med Rev. 2004;8(2):119-32.
- 11. Sağlam G, Aküzüm F, Çetinkaya Alişar D. Assessment of psychiatric disorders and sleep quality in chronic lateral epicondylitis. Kronik lateral epikondilitte psikiyatrik bozuklukların ve uyku kalitesinin değerlendirilmesi. Agri. 2022;34(3):193-9.
- 12. Sampaio RA, Sewo Sampaio PY, Yamada M, Tsuboyama T, Arai H. Self-reported quality of sleep is associated with bodily pain, vitality and cognitive impairment in Japanese older adults. Geriatr Gerontol Int. 2014;14(3):628-35.
- 13. Altan L, Ercan I, Konur S. Reliability and validity of Turkish version of the patient rated tennis elbow evaluation. Rheumatol Int. 2010;30(8):1049-54.
- 14. Rompe JD, Overend TJ, MacDermid JC. Validation of the Patient-rated Tennis Elbow Evaluation Questionnaire. J Hand Ther. 2007;20(1):3-11.
- 15. Ikpeze TC, Smith HC, Lee DJ, Elfar JC. Distal Radius Fracture Outcomes and Rehabilitation. Geriatr Orthop Surg Rehabil. 2016;7(4):202-5.
- 16. Yalin M, Golgelioglu F, Key S. The ageless approach: Nonoperative mastery competes head-on with surgery for elderly distal radius fractures. J Orthop Res. 2024;42(1):141-7.
- 17. Ha E, Lho YM, Seo HJ, Cho CH. Melatonin Plays a Role as a Mediator of Nocturnal Pain in Patients with Shoulder Disorders. J Bone Joint Surg Am. 2014;2;96(13):e108.
- 18. Mulligan EP, Brunette M, Shirley Z, Khazzam M. Sleep quality and nocturnal pain in patients with shoulder disorders. J Shoulder Elbow Surg. 2015;24(9):1452-7.
- 19. da Luz DC, de Borba Y, Ravanello EM, Daitx RB, Döhnert MB. Iontophoresis in lateral epicondylitis: a randomized, double-blind clinical trial. J Shoulder Elbow Surg. 2019;28(9):1743-9.
- 20. Austin L, Pepe M, Tucker B, Ong A, Nugent R, Eck B, et al. Sleep disturbance associated with rotator cuff tear: correction with arthroscopic rotator cuff repair. Am J Sports Med. 2015;43(6):1455- 9.
- 21. Serbest S, Tiftikçi U, Askın A, Yaman F, Alpua M. Preoperative and post-operative sleep quality evaluation in rotator cuff tear patients. Knee Surg Sports Traumatol Arthrosc. 2017;25(7):2109-13.
- 22. Horneff JG 3rd, Tjoumakaris F, Wowkanech C, Pepe M, Tucker B, Austin L. Long-term Correction in Sleep Disturbance Is Sustained After Arthroscopic Rotator Cuff Repair. Am J Sports Med. 2017;45(7):1670- 5.
- 23. Minns Lowe CJ, Moser J, Barker K. Living with a symptomatic rotator cuff tear 'bad days, bad nights': a qualitative study. BMC Musculoskelet Disord. 2014;15:228.
- 24. Herquelot E, Bodin J, Roquelaure Y, Ha C, Leclerc A, Goldberg M, et al. Work-related risk factors for lateral epicondylitis and other cause of elbow pain in the working population. Am J Ind Med. 2013;56(4):400-9.
- 25. Savoie FH 3rd, O'Brien MJ. Arthroscopic tennis elbow release. Instr Course Lect. 2015;64:225-30.
- 26. Babaqi AA, Kotb MM, Said HG, AbdelHamid MM, ElKady HA, ElAssal MA. Short-term evaluation of arthroscopic management of tennis elbow; including resection of radio-capitellar capsular complex. J Orthop. 2014;11(2):82-6.
- 27. Behazin M, Kachooei AR. Arthroscopic Recession Technique in the Surgery of Tennis Elbow by Sharp Cutting the Extensor Carpi Radialis Brevis (ECRB) Tendon Origin. Arch Bone Jt Surg. 2021;9(2):174-9.
- 28. Evans JP, Porter I, Gangannagaripalli JB, Bramwell C, Davey A, Smith CD, et al. Assessing Patient-Centred Outcomes in Lateral Elbow Tendinopathy: A Systematic Review and Standardised Comparison of English Language Clinical Rating Systems. Sports Med Open. 2019;5(1):10.
- 29. Barandiaran AF, Houck DA, Schumacher AN, Seidl AJ, Frank RM, Vidal AF, et al. Shoulder Surgery as an Effective Treatment for Shoulder-Related Sleep Disturbance: A Systematic Review. Arthroscopy. 2022;38(3):989-1000.e1.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Ortopedi |
| Bölüm | Orjinal Çalışma |
| Yazarlar | |
| Yayımlanma Tarihi | 15 Haziran 2025 |
| Gönderilme Tarihi | 7 Aralık 2024 |
| Kabul Tarihi | 2 Nisan 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 15 Sayı: 2 |
