Editorial Commentary: Don't Let Cuff Tears With Adhesive Capsulitis Give You the Cold Shoulder

Despite vastly different rehabilitation goals, adhesive capsulitis and a rotator cuff tear of the shoulder can be treated concomitantly with good outcomes. In the face of adhesive capsulitis, rotator cuff tears can be safely repaired with manipulation under anesthesia and/or capsular release without a substantial increase in complication rates compared with patients undergoing rotator cuff repair alone. Adhesive capsulitis pathology causes the cuff to heal rapidly, and we recommend aggressive passive range of motion as part of a traditional but accelerated rehabilitation that can be monitored and thus adjusted on a case-by-case basis.
Source: Arthroscopy - Journal of Arthroscopic and Related Surgery - Category: Surgery Authors: Tags: Editorial Commentary Source Type: research

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BACKGROUND Ultrasound-guided interscalene block (ISB) is the reference technique for pain control after ambulatory upper limb surgery, but supraclavicular block (SCB) is an alternative. OBJECTIVES The aim of this study was to compare the efficacy of SCB vs. ISB in patients undergoing ambulatory arthroscopic rotator cuff repair (ARCR), with the hypothesis of noninferiority of SCB analgesia compared with ISB. DESIGN A randomised, single-blind, noninferiority study. SETTING Hôpital Privé Jean Mermoz, Centre Paul Santy, Lyon, France. PATIENTS Ambulatory ARCR patients. INTERVENTION Patients were ra...
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Loco-regional anaesthesia Source Type: research
Condition:   Rotator Cuff Tears Interventions:   Drug: Lidocaine;   Drug: Normal saline Sponsor:   Yonsei University Completed
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
AbstractIntroductionTo determine whether the placement of an interscalene brachial plexus block (IBPB) with general anaesthesia before shoulder arthroscopy would be effective in establishing a clear visual field and in shortening the surgical procedure.MethodThis prospective randomized control trial study included 152 patients who had undergone arthroscopic rotator cuff repair. Group A received IBPB and group B did not receive IBPB. A visual clarity scale (VCS) was determined by arthroscopic visualization. The systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), duration of surgical procedure, VC...
Source: International Orthopaedics - Category: Orthopaedics Source Type: research
ConclusionPatients with an isolated ramp lesion of the medial meniscus in association with an ACL injury displayed a higher amount of dynamic rotational laxity as expressed by the pivot shift test in comparison to patients with isolated ACL injury and no ramp lesion. The association between ramp lesions of the medial meniscus and increased pivot shift grading suggests that it is important to diagnose and repair them during ACL reconstruction surgery.Level of evidenceIII.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
Publication date: Available online 8 June 2019Source: Journal of Clinical Orthopaedics and TraumaAuthor(s): Ujjwal K. Debnath, Vivek Goel, Sahil Saini, Neev Trehan, Ravi TrehanAbstractBackground &purposeThe recent advances in anaesthesia and analgesia have significantly improved the early recovery and effective post-operative pain control in day care surgery e.g. shoulder; arthroscopic procedures. Adequate analgesia improves the early rehabilitation for a better outcome. We prospectively evaluated the post-operative pain relief following the two methods of analgesia i.e. regional Inter-scalene block (ISB) vs Intra-arti...
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
CONCLUSION Paracetamol/metamizole and paracetamol/ibuprofen are equally effective in treatment of acute postoperative pain at home after ambulatory surgery with comparable patient satisfaction levels. TRIAL REGISTRATION European Union Clinical Trials Register 2015-003987-35.
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Postoperative pain Source Type: research
Arthroscopic rotator cuff repair (ARCR) provides excellent clinical outcomes but is often associated with significant postoperative pain. The use of intraoperative anesthesia in conjunction with multimodal pharmacologic  strategies is a widely accepted approach for managing surgical pain and reducing opiate use. The purpose of this study was to determine whether using a combined field and suprascapular nerve block with liposomal bupivacaine (LB) in addition to an interscalene block would provide greater pain reli ef and a reduction in opiate consumption compared with an interscalene block alone.
Source: Journal of Shoulder and Elbow Surgery - Category: Orthopaedics Authors: Source Type: research
Conclusions: Open operative treatment within the first 3 weeks of injury with primary repair or reconstruction of all injured structures can yield outcomes similar to those reported in patients treated with delayed or staged reconstruction of ligaments. Early treatment allows definitive management of injuries that are difficult to address on a delayed basis. Complications of infection, revision because of laxity, and stiffness are uncommon with this approach.
Source: Techniques in Orthopaedics - Category: Orthopaedics Tags: Special Technical Articles Source Type: research
Surgery and pain pills used to go hand in hand. After all, you need a strong prescription pain medication to ensure you aren’t in pain after a procedure, right? Turns out not only is prescription pain medication not always needed, but often not advisable after surgery, because it can raise the risk of opioid addiction. As a result, surgeons today are rethinking post-surgical pain management strategies. And if you’re going under the knife, you should too. In the 1990s, the number of opioid prescriptions written for people undergoing surgery or experiencing pain conditions grew — and so did related problems...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Pain Management Surgery Source Type: blogs
Rationale: Variant angina is characterized by coronary artery spasm irrespective of the presence of fixed stenotic coronary lesions. Perioperative coronary artery spasm may be induced by the supersensitivity of vascular smooth muscle cells caused by various stimuli, including stimulation of the parasympathetic nervous system. Patient concerns: A 57-year-old male patient was undergoing arthroscopic rotator cuff repair under combined interscalene brachial plexus block and general anesthesia in the lateral decubitus position. While compressing the right shoulder to remove residual irrigation fluid in the shoulder through...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
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