Comparison of Subacromial Injection and Interscalene Block for Immediate Pain Management Following Arthroscopic Rotator Cuff Repair
To compare the efficacy of a subacromial injection (SAI) to a single-shot interscalene block (ISB) for immediate postoperative pain relief following outpatient arthroscopic rotator cuff repair (ARCR).
To compare the efficacy of a subacromial injection (SAI) with a single-shot interscalene block (ISB) for immediate postoperative pain relief after outpatient arthroscopic rotator cuff repair (ARCR).
Authors: Otte RS, Bansal A, Srikumaran U, Weick JW, Freehill MT, Lin A, Garrigues GE Abstract Rotator cuff pathology is one of the most common reasons for patients to seek orthopaedic consultation. Although in many cases these issues can be resolved with proper conservative management, many of these patients benefit from surgical treatment. The goal of this instructional course lecture is to identify factors that can potentially lead to worse outcomes following repair, describe the history and techniques behind transosseous anchorless repairs, discuss subscapularis tears and their management, and to analyze the mos...
Authors: Adams JE, Kaplan J, Rosenbaum JA, Sotereanos DG, Stern PJ, Rosenwasser MP Abstract This chapter will explore scapholunate ligament injuries with a focus on injury recognition, diagnosis, the natural history, and options for treatment. Treatment is based upon injury factors, patient factors, and surgeon preference. The classification systems in common use will be discussed, and treatment options will be explored, including nonsurgical, arthroscopic, repair, reconstruction, pain relieving measures, and salvage procedures. PMID: 32017736 [PubMed - in process]
ConclusionCapsular repair has the potential to improve patient reported outcomes after hip arthroscopy. While there was no consensus in literature, studies consistently reported similar or superior outcomes in the capsular repair cohorts compared to capsular release. Further randomized controlled studies need to be conducted for better evaluation of outcomes.
ConclusionWith this local –regional nerve-blocking protocol, opioid use after ARCR was unexpectedly low, and a large proportion of patients recovered without any post-surgical opioids. The correlation seen between opioid use and age may not be clinically significant, given the low use of post-operative opioids overall. The se results may be useful in guiding post-operative opioid prescribing after ARCR, as well as in lowering costs associated with ARCR.
ConclusionThe findings suggest that patients undergoing shoulder surgery have high overall preoperative expectations, which were significantly associated with ethnicity, surgical history, opioid use, and employment status, and with multiple patient-reported outcome measures including physical function, pain interference, fatigue, and depression. Nevertheless, by discussing expectations preoperatively, orthopaedic surgeons can help patients develop high but realistic expectations to improve outcomes and satisfaction.Level of evidenceIV.
CONCLUSION: In patients with unstable elbow dislocation, with or without an intra-articular fracture, arthroscopic repair of the LCL complex is an effective and alternative treatment option that can restore elbow stability and have satisfactory clinical and radiographic results. PMID: 32148153 [PubMed - in process]
Abstract Factors motivating patients to undergo rotator cuff repair (RCR) have not been thoroughly investigated. The purpose of this study was to investigate patient and surgeon decision-making factors for RCR, as well as the use of conservative treatment, and their relationship with shoulder function. A total of 144 adult patients undergoing arthroscopic RCR completed a 13-item questionnaire assessing the importance of surgical decision-making factors. Preoperative conservative treatments were also recorded. Surgeons also completed a similar 5-item questionnaire assessing surgeon decision-making factors preoperat...
Hip abductor tendon tears or tears of the gluteus medius and minimus is a common etiology of lateral hip pain, especially in females between the fourth and sixth decade. Abductor tears are often associated with severe functional impairment including hip abduction weakness and Trendelenburg gait. Excellent outcomes have been demonstrated using open repair with an increasing interest in endoscopic management. The purpose of this study is to add to the growing body of evidence by prospectively evaluating the short-term outcomes of endoscopic repair of full and partial abductor tendon tears, with a minimum of 1-year follow-up.
Post-operative pain following rotator cuff repair is commonly managed through the use of opioid medications; however, these medications are associated with serious adverse effects. Relaxation exercises represent a potential non-pharmacologic method of pain management that can be easily implemented without significant adverse effects. The purpose of this investigation was to evaluate the effects of relaxation exercises on post-operative pain and narcotics use after ARCR.