Synchronization of Blood Flow Velocity in the Anterior Humeral Circumflex Artery and Reduction in Night Pain After Arthroscopic Rotator Cuff Repair: A Case Report

Rotator cuff tears are commonly associated with pain at rest and at night particularly if lying on the affected shoulder. This case describes a 54-year-old man who reported concerns of severe night pain in his left shoulder and had to undergo arthroscopic rotator cuff repair. The severity of night pain and blood flow velocity in the anterior humeral circumflex artery (AHCA) were measured over time. The patient reported his night pain as 10/10 on the numerical rating scale in the first week after surgery. In the fourth week, he rated his night pain as 6/10, and in the fifth week, his pain was <2/10. We measured blood flow velocity in the MICA using a 3-11MHz color Doppler and power Doppler ultrasound (SONIMAGE HS2, Konica Minolta, Tokyo, Japan), and we calculated peak systolic velocity. The course of peak systolic velocity in the AHCA ranged from 27.7 to 62.4 cm/s until four weeks after surgery when his night pain was severe; AHCA flow velocity ranged from 16.7 to 19.3 cm/s five weeks after surgery when his night pain had reduced. The initially high blood flow velocity in the MICA decreased almost simultaneously with the improvement in night pain. Our case highlights that blood flow velocity in the AHCA synchronized with the severity of night pain, which may contribute to the understanding of sleep disturbances in patients after arthroscopic rotator cuff repair.