Metabolic Syndrome and Persistent Shoulder Pain 1 Year After Primary Diagnosis
Metabolic Syndrome and Persistent Shoulder Pain 1 Year After Primary Diagnosis
In a longitudinal cohort project, the objective is to evaluate general prognostic and
 individual risk factors for long lasting shoulder pain, with a specific focus on evaluation
 of the association between metabolic syndrome and tendinopathy, while simultaneous adjusting
 for other potential prognostic candidate variables (PROGRESS Theme I-II).
The VHS Cohort is a prospective cohort trial evaluating a wide range of patient reported and
 clinical prognostic factors, attained prior to initiation of treatment, among shoulder
 patients referred for diagnostic evaluation at the specialized shoulder unit at Vejle
 Hospital, Denmark. The department receives approximately 2000 new patients each year.

 Prior to medical examination, patients will be asked to fill in a baseline questionnaire, and
 from the electronic patient record, a range of different clinical factors will be obtained.

 Subsequently, patients will be asked to answer questionnaires on patient reported outcomes
 after 1, 3, 6, and 12 months. Five years after inclusion into the trial, work affiliation
 will be retrieved from registries in order to evaluate association between shoulder disorders
 and work affiliation.

 The objective of the VHS Cohort Project is to evaluate general prognostic and individual risk
 factors for long lasting shoulder pain. A specific focus is evaluation of the association
 between metabolic syndrome and rotator cuff tendinopathy while simultaneously adjusting for
 other potential prognostic candidate variables (PROGRESS Theme I-II). In a subsequent cohort
 (VHS Cohort Project II), the objective will be to develop a prognostic model for the
 treatment effect of Rotator Cuff Related Shoulder Pain (RCRSP) (PROGRESS Theme III).

 VHS Cohort Project I:

 Aim 1: Evaluate the risk of consistent pain one year after diagnosis among patients diagnosed
 with: RCRSP; Rotator cuff lesions (conservatively treated); Acromioclavicular osteoarthritis
 and Adhesive capsulitis (PROGRESS Theme I).

 Aim 2: Evaluate the risk of consistent pain one year after surgery for: subacromial
 Decompression OR Rotator Cuff lesion (PROGRESS Theme I).

 Aim 3: Evaluate the risk of consistent pain one year after diagnosis in patients with
 metabolic syndrome compared to patients without metabolic syndrome, with particular emphasis
 on patients diagnosed with RCRSP while simultaneously adjusting for other potential
 prognostic candidate variables (PROGRESS Theme II).

 We hypothesize that

 -  Significantly more patients with RCRSP have metabolic syndrome than patients diagnosed
 with other shoulder-specific diagnoses

 -  Significantly more patients with metabolic syndrome and diagnosed with RCRSP are
 classified as non-responders to treatment than patients with other shoulder specific
 diagnoses 52 weeks after initial medical examination.

 -  Significantly more shoulder patients with metabolic syndrome report multiple
 musculoskeletal pain sites than shoulder patients without metabolic syndrome at first
 medical examination.

 Aim 4: From clinical examination findings and patient reported information identify the
 strongest individual predictors of prognostic value for persistent shoulder pain and
 disability one year after initial medical examination in patients with rotator cuff related
 pain syndrome (RCRSP) (Diagnostic codes: DM75.1; DM75.1A; DM75.1B; DM75.4; DM75.5; DM75.8;
 DM75.9) treated conservatively with either exercise, corticosteroid injection, or a
 combination of the two, while simultaneously adjusting for other potential prognostic
 candidate variables (PROGRESS Theme II).

 Aim 5: From clinical examination findings and patient reported information identify the
 strongest individual preoperative predictors of prognostic value for persistent shoulder pain
 and disability one year after surgery for patients receiving SubAcromial Decompression (SAD)
 surgery (Procedure code: KNBH51), while simultaneous adjusting for other potential prognostic
 candidate variables (PROGRESS Theme II).

 Aim 6: From clinical examination findings and patient reported information, identify the
 strongest individual predictors of five-year work participation rates.
Inclusion Criteria:

 -  Referred for medical examination to the shoulder sector, orthopedic Department, Vejle
 Hospital - Hospital Lillebaelt

 -  Older than 18 years

 -  Diagnosed with shoulder disorder at medical examination.

 Exclusion Criteria:

 -  Significant cognitive impairment or language issues

 -  Symptomatic cervical spine pathology

 -  Older than 75 years.