26dkou509 10.3205/26dkou509 urn:nbn:de:0183-26dkou5095 Meeting Abstract Brune Brune Daniela D

Teaching, Research and Development Upper Extremities, Schulthess Klinik, Zürich, Schweiz

author Freislederer Freislederer Florian F

Department Shoulder and Elbow Surgery, Schulthess Klinik, Zürich, Schweiz

author George George Steven Z. SZ

Departments of Orthopedic Surgery and Population Health Sciences, Duke Clinical Research Institute, Duke School of Medicine, Durham, NC, USA

author Edwards Edwards Robert R. RR

Department of Anesthesiology, Brigham & Women’s Hospital and Harvard Medical School, Boston, USA

author Scheibel Scheibel Markus M

Department of Anesthesiology, Brigham & Women’s Hospital and Harvard Medical School, Boston, Department Shoulder and Elbow Surgery, Schulthess Klinik, Zürich, Schweiz

author Lazaridou Lazaridou Asimina A

Department of Anesthesiology, Brigham & Women’s Hospital and Harvard Medical School, Boston, Teaching, Research and Development Upper Extremities, Schulthess Klinik, Zürich, Schweiz

author German Medical Science GMS Publishing House

Düsseldorf

610 20261020 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0659 509 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie Deutsche Gesellschaft für Unfallchirurgie Berufsverband für Orthopädie und Unfallchirurgie Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2026) Poster | Schulter und Ellenbogen Berlin 20261020 20261023 DKOU26_Abs_2411 TextObjectives and questions: Total shoulder arthroplasty (TSA) often relieves pain and restores function, yet many patients continue to experience persistent pain and sleep disturbance postoperatively. These symptoms are closely interrelated, with poor sleep amplifying pain and pain disrupting sleep, forming a bidirectional cycle that hinders recovery. Psychological factors, particularly negative affect, have the potential to further influence this relationship. The present study examined the interrelations among changes in pain, sleep disturbance, and negative affect over two years following TSA.Material and methods: This retrospective cohort study used data from a local shoulder arthroplasty registry including patients with primary anatomic and reverse TSA and complete baseline and two-year follow-up data. Sleep disturbance and negative affect were assessed using individual items from the QuickDASH, and EQ-5D-5L, respectively; pain intensity was assessed using numeric rating scale. Changes in these measures were calculated as differences between pre-surgery and two-year follow-up values. Pearson correlations (p < .01) examined associations among change scores in these measures and mediation analyses evaluated indirect effects of sleep and pain on negative affect.Results: A total of 944 registry corresponding to 874 unique patients (mean age 73.4 ± 8.2 years, 64% female) were analyzed. Increases in sleep disturbance significantly associated with increases in pain, with negative affect contributing a modest but significant indirect effect (a*b = 0.02, p = .016), mediating 2.5% of the total effect. In addition, increases in negative affect were significantly related to greater pain, predominantly via elevated sleep disturbance (a*b = 0.14, p = .0020), accounting for 30% of the total effect. Exploratory subgroup analyses revealed full mediation by sleep disturbance in reverse TSA (a*b = 0.15, p = .0028) and cuff tear arthropathy (a*b = 0.18, p = .0016), but not in anatomic TSA or osteoarthritis.Discussion and conclusions: These findings highlight a bidirectional relationship between sleep disturbance and pain following shoulder arthroplasty, with sleep disturbance emerging as an important pathway linking negative affect and pain. Integrating mood and sleep management into prehabilitation in shoulder arthroplasty may assist in enhancing pain relief and promote optimal long-term recovery. 0 0 0 0