No Difference in Clinical Outcomes and Return to Sport & Work with Use of Postoperative Non-Steroidal Anti-Inflammatory Medications Following Primary Arthroscopic Glenoid Labral Repair.
Zachary I Li, Nathan A Huebschmann, Sharif Garra, Jordan Eskenazi, Samantha A Rettig, Edward S Mojica, Michael J Alaia, Eric J Strauss, Laith M Jazrawi, Kirk A Campbell
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引用次数: 0
Abstract
Background: To compare clinical outcomes, return to activities, and rates of revision surgery following arthroscopic glenoid labral repair in patients who were prescribed NSAIDs as part of their postoperative pain management regimen versus those who were not.
Methods: Patients aged 18-55 who underwent primary arthroscopic labral repair at a single academic institution from the years 2016-2020 were retrospectively reviewed. Patients who underwent concomitant rotator cuff repair, remplissage, or did not have minimum 2-year postoperative follow-up were excluded. Patients who were prescribed postoperative NSAIDs were matched 1:1 to those who were not based on age, sex, BMI, and number of suture anchors. Outcomes were assessed using the Visual Analog Scale (VAS) for pain, American Shoulder and Elbow Surgeons Shoulder Score (ASES), Simple Shoulder Test (SST), Single Assessment Numeric Evaluation rating (SANE), and satisfaction. Pre-injury sport and work activity information were recorded.
Results: Of 269 eligible patients, 224 patients were included. Patients prescribed NSAIDs postoperatively had similar levels of pain (1.2 vs 1.0, p=0.527) and function (ASES: 90.8 vs 89.9, p=0.824; SST: 91.9 vs 90.6, p=0.646; SANE: 83.8 vs 85.3, p=0.550) compared to those who were not. Rates of revision surgery (2.7% vs 0.9%, p=0.622) and recurrent instability (5.4% vs 8.0%, p=0.594) were similar between NSAID and non-NSAID groups. Rates of return to sport (83.5% vs 77.8%, p=0.318) and return to pre-injury level (59.3% vs 61.6%, p=0.177) were similar between NSAID and non-NSAID groups. Prescription of postoperative NSAIDs was not associated with delayed return to sport (OR:1.47, 95%CI [0.68,3.18], p=0.327) or return to work (OR:0.56, 95%CI [0.14,2.28], p=0.416).
Conclusions: Patients who were prescribed NSAIDs as a part of a postoperative pain management regimen following primary arthroscopic labral repair for glenohumeral instability had similar patient-reported outcomes, revision rates, and rates of return to pre-injury activities compared to those who were not prescribed NSAIDs.
背景：目的：比较作为术后疼痛治疗方案一部分被处方非甾体抗炎药与未被处方非甾体抗炎药的患者在关节镜下盂唇修复术后的临床疗效、活动恢复情况和翻修手术率：对 2016-2020 年间在一家学术机构接受初次关节镜下盂唇修复术的 18-55 岁患者进行回顾性研究。排除了同时接受肩袖修复术、再植术或术后未进行至少 2 年随访的患者。根据年龄、性别、体重指数（BMI）和缝合锚的数量，将术后服用非甾体抗炎药的患者与未服用非甾体抗炎药的患者进行1:1配对。评估结果采用疼痛视觉模拟量表（VAS）、美国肩肘外科医生肩部评分（ASES）、简单肩部测试（SST）、单一评估数字评价等级（SANE）和满意度。此外，还记录了受伤前的运动和工作活动信息：结果：在269名符合条件的患者中，224名患者被纳入其中。与未使用非甾体抗炎药的患者相比，术后患者的疼痛（1.2 vs 1.0，p=0.527）和功能（ASES：90.8 vs 89.9，p=0.824；SST：91.9 vs 90.6，p=0.646；SANE：83.8 vs 85.3，p=0.550）水平相似。非甾体抗炎药组和非非甾体抗炎药组的翻修手术率（2.7% vs 0.9%，p=0.622）和复发性不稳定率（5.4% vs 8.0%，p=0.594）相似。非甾体抗炎药组和非非甾体抗炎药组的恢复运动率（83.5% vs 77.8%，p=0.318）和恢复到受伤前水平的比率（59.3% vs 61.6%，p=0.177）相似。术后处方非甾体抗炎药与延迟恢复运动（OR：1.47，95%CI [0.68,3.18]，p=0.327）或恢复工作（OR：0.56，95%CI [0.14,2.28]，p=0.416）无关：结论：与未使用非甾体抗炎药的患者相比，在关节镜下进行盂肱关节不稳的髋关节唇修复术后，使用非甾体抗炎药作为术后疼痛治疗方案的患者在患者报告的治疗效果、翻修率和恢复受伤前活动的比率方面均与未使用非甾体抗炎药的患者相似。
期刊介绍：
The official publication for eight leading specialty organizations, this authoritative journal is the only publication to focus exclusively on medical, surgical, and physical techniques for treating injury/disease of the upper extremity, including the shoulder girdle, arm, and elbow. Clinically oriented and peer-reviewed, the Journal provides an international forum for the exchange of information on new techniques, instruments, and materials. Journal of Shoulder and Elbow Surgery features vivid photos, professional illustrations, and explicit diagrams that demonstrate surgical approaches and depict implant devices. Topics covered include fractures, dislocations, diseases and injuries of the rotator cuff, imaging techniques, arthritis, arthroscopy, arthroplasty, and rehabilitation.
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