Arthroscopy-The Journal of Arthroscopic and Related Surgery最新文献

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Repair of Isolated Subscapularis Tears With Concurrent Biceps Tenodesis Using a Single Anchor Results in Satisfactory Clinical Outcomes: Minimum 2-Year Follow-Up. 使用单锚修复孤立的肩胛下肌撕裂,同时进行肱二头肌腱膜切除术,临床效果令人满意:至少两年的随访。
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2024-08-10 DOI: 10.1016/j.arthro.2024.07.026
Ethem Burak Oklaz, Asim Ahmadov, Furkan Aral, Muhammed Furkan Tosun, Inci Hazal Ayas, Ulunay Kanatli
{"title":"Repair of Isolated Subscapularis Tears With Concurrent Biceps Tenodesis Using a Single Anchor Results in Satisfactory Clinical Outcomes: Minimum 2-Year Follow-Up.","authors":"Ethem Burak Oklaz, Asim Ahmadov, Furkan Aral, Muhammed Furkan Tosun, Inci Hazal Ayas, Ulunay Kanatli","doi":"10.1016/j.arthro.2024.07.026","DOIUrl":"10.1016/j.arthro.2024.07.026","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the clinical outcomes of patients treated with isolated subscapularis tear repair and biceps tenodesis using a single anchor.</p><p><strong>Methods: </strong>Patients diagnosed with subscapularis tear and who underwent arthroscopic surgery by a single surgeon between February 2017 and January 2022 were evaluated retrospectively. Inclusion criteria were patients who underwent repair of isolated subscapularis tear along with tenodesis for long head of the biceps tendon pathologies such as SLAP lesion, instability, partial tear, or tenosynovitis, with a minimum follow-up of 24 months. Assessment included active and passive range of motion, single-assessment numeric evaluation (SANE), visual analog scale (VAS), Constant-Murley score (CMS), and specific subscapularis and biceps tests. Improvements were analyzed using minimum clinically important difference (MCID) values.</p><p><strong>Results: </strong>A total of 20 patients were included. The mean age was 48.5 ± 7 years, and the follow-up period was 43.1 ± 12.7 months. Significant improvements were observed at the final follow-up in active forward flexion, active abduction, active internal rotation, as well as VAS, SANE, and CMS (P < .001). The MCID analysis showed that 100% of patients met the MCID for CMS, 90% for SANE, and 100% for VAS.</p><p><strong>Conclusions: </strong>In the presence of an isolated subscapularis tear associated with long head of the biceps tendon pathologies, favorable clinical outcomes could be achieved by performing both tear repair and biceps tenodesis with a double-loaded single anchor. Most patients (>90%) achieved the MCID for the CMS, SANE, and VAS, indicating significant clinical improvement and satisfactory patient outcomes.</p><p><strong>Level of evidence: </strong>Level IV, case series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Letter to the Editor REPLY. 致编辑的信 答复。
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2024-08-10 DOI: 10.1016/j.arthro.2024.08.005
William A Berrigan
{"title":"Letter to the Editor REPLY.","authors":"William A Berrigan","doi":"10.1016/j.arthro.2024.08.005","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.08.005","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hip Circumferential Labral Reconstruction Provides Similar Distractive Stability to Labral Repair After Cam Over-Resection in a Biomechanical Model. 在生物力学模型中,凸轮过度切除后的髋关节环状韧带重建术与韧带修复术具有相似的分散稳定性。
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2024-08-10 DOI: 10.1016/j.arthro.2024.07.023
Alexander J Hoffer, Stefan A St George, Brent A Lanting, Ryan M Degen, K C Geoffrey Ng
{"title":"Hip Circumferential Labral Reconstruction Provides Similar Distractive Stability to Labral Repair After Cam Over-Resection in a Biomechanical Model.","authors":"Alexander J Hoffer, Stefan A St George, Brent A Lanting, Ryan M Degen, K C Geoffrey Ng","doi":"10.1016/j.arthro.2024.07.023","DOIUrl":"10.1016/j.arthro.2024.07.023","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the change in hip distractive stability after a cam over-resection, labral tear, repair, labrectomy, or circumferential 6- or 10-mm labral reconstruction in a biomechanical model.</p><p><strong>Methods: </strong>Ten fresh-frozen matched-pair human cadaveric hips were analyzed using a materials testing system to measure the force and distance required to disrupt the suction seal of the hip (1) with an intact capsule and labrum; (2) after a capsulectomy and labral repair; (3) after a capsulectomy, 5-mm cam over-resection and labral repair; (4) after a capsulectomy, 5-mm cam over-resection and labral tear; (5) after a capsulectomy, 5-mm cam over-resection and labrectomy; and (6) after a capsulectomy, 5-mm cam over-resection and a 6- or 10-mm circumferential labral reconstruction with iliotibial band (5 hips each). Each specimen was retested at 0° flexion, 45° flexion, and 45° flexion and at 15° internal rotation and analyzed using nonparametric statistical methods.</p><p><strong>Results: </strong>The Friedman test of differences was significant among structural conditions and hip positions (P = .001). In all positions, the resistive force that opposed the disruption of the suction seal in an intact hip was significantly greater compared with all other conditions. The resistive force for the capsulectomy, 5-mm cam over-resection and labrectomy condition was significantly less compared with almost all other conditions and hip positions. A qualitative suction seal was achieved in 20% of hip specimens with a 6-mm labral reconstruction, whereas a seal was in achieved 60% of specimens with a 10-mm labral reconstruction.</p><p><strong>Conclusions: </strong>After a cam over-resection, a circumferential labral reconstruction improves the distractive stability of a labral deficient hip, comparable to a labral repair or tear in a biomechanical model.</p><p><strong>Clinical relevance: </strong>Circumferential labral reconstruction may be a viable treatment option for patients with ongoing symptoms after hip arthroscopy with evidence of a cam over-resection and a deficient labrum.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Decreasing Incidence of Partial Meniscectomy and Increasing Incidence of Meniscus Preservation Surgery From 2010 to 2020 in the United States. 2010-2020 年美国半月板部分切除手术的发生率下降,半月板保留手术的发生率上升。
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2024-08-10 DOI: 10.1016/j.arthro.2024.07.030
Victoria E Bergstein, Uzoma Ahiarakwe, Mark Haft, Jacob D Mikula, Matthew J Best
{"title":"Decreasing Incidence of Partial Meniscectomy and Increasing Incidence of Meniscus Preservation Surgery From 2010 to 2020 in the United States.","authors":"Victoria E Bergstein, Uzoma Ahiarakwe, Mark Haft, Jacob D Mikula, Matthew J Best","doi":"10.1016/j.arthro.2024.07.030","DOIUrl":"10.1016/j.arthro.2024.07.030","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the incidence of meniscus surgery from 2010 to 2020 in the United States, using the metrics of age, sex, type of meniscus surgery, and Charlson Comorbidity Index (CCI).</p><p><strong>Methods: </strong>A retrospective analysis was performed using the PearlDiver national insurance claims database from 2010 to 2020. Meniscus surgeries were identified using Current Procedural Terminology codes. Patients were stratified by procedure type, age, biological sex, and CCI scores. Compound annual growth rate analysis and analysis of variance were performed to analyze the trends and demographic variables between cohorts.</p><p><strong>Results: </strong>Of 2,053,884 meniscus surgeries, 94.7% were meniscectomies, 0.3% were open repairs, 4.9% were arthroscopic repairs, and 0.1% were meniscal transplantations. Compound annual growth rate analysis displayed a 4.0% decrease per year in total meniscus surgery. For individual procedure types, the largest decrease was in meniscectomy, and the largest increase was in open repair. Patients undergoing meniscal transplantation were youngest, with the lowest CCI. Meniscectomy patients were oldest, and open repair patients had the highest average CCI. Most procedures were performed on female patients (52.4%) and patients in the 50- to 59-year age group (30.4%).</p><p><strong>Conclusions: </strong>There was a sustained decrease in the incidence of total meniscus surgeries from 2010 to 2020. Meniscectomy was the procedure with the highest incidence, but it showed the most significant decline in usage over the study period. Conversely, meniscal repair and transplantation procedures increased during the study period.</p><p><strong>Level of evidence: </strong>Level IV, epidemiologic study.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Incomplete histologic healing and diminished biomechanical strength of meniscus-bone interface after medial meniscus posterior root transosseous repair in a goat model. 在山羊模型中进行内侧半月板后根经骨修复后,半月板-骨界面的组织学愈合不完全,生物力学强度降低。
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2024-08-09 DOI: 10.1016/j.arthro.2024.07.024
Xing-Hao Deng, Jing-Song Wang, Zhong Chen, Wei-Ke Zeng, Hua-Ming Peng, Wan-Ting Yan, Chuan Jiang, Bin Song, Wei-Ping Li, Zheng-Zheng Zhang
{"title":"Incomplete histologic healing and diminished biomechanical strength of meniscus-bone interface after medial meniscus posterior root transosseous repair in a goat model.","authors":"Xing-Hao Deng, Jing-Song Wang, Zhong Chen, Wei-Ke Zeng, Hua-Ming Peng, Wan-Ting Yan, Chuan Jiang, Bin Song, Wei-Ping Li, Zheng-Zheng Zhang","doi":"10.1016/j.arthro.2024.07.024","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.07.024","url":null,"abstract":"<p><strong>Purpose: </strong>To enhance the understanding of histological healing after repairing medial meniscal posterior root tear (MMPRT) at an early stage, utilizing a goat model.</p><p><strong>Methods: </strong>Eighteen adult goats, totaling thirty-six knee joints, were allocated into three groups (n = 12): Sham group (Sham), Root Tear group (RT), and Root Tear with Transosseous Suture group (RTS). At 12- and 24-week intervals post-surgery, all the knees were harvested for imaging, macroscopic, histological, and biomechanical assessments.</p><p><strong>Results: </strong>The intact root served as a meniscus-bone interface which connected the tibial and the circular fibers of the meniscus, with a bony insertion and a root-meniscus transition. A direct-fibrous-connection displayed at the bony insertion proximal to the synovium in the RTS group, while the remaining regions of the root displayed indirect-fibrous healing. The healing in the RT group was disjointed and reminiscent of scar tissue. The RTS group exhibited a more pronounced coronal extrusion compared to the Sham group (0.42 ± 0.09 vs. 0.19 ± 0.02, P = 0.0012) but was improved relative to that of the RT group (0.49 ± 0.02, P = 0.0028). The failure load and stiffness of the RTS group were notably higher than those of the RT group, with a strength of 42.67% and a stiffness of 83.75% of the intact root. All the samples ruptured at the root-meniscus transitions.</p><p><strong>Conclusion: </strong>The incomplete healing may be attributed to the histological factors underlying the low healing rate and persistent MME. Notably, the region attached to the posterior-cruciate-ligament exhibited superior healing compared to other regions of the bony insertion in the repaired group. Conversely, the root-meniscus transition displayed discontinuity, representing a mechanical weakness in the healing process.</p><p><strong>Clinical relevance: </strong>Modifications of bone tunnel positioning and suture placement could be undertaken in subsequent studies to particularly enhance the healing of the root-meniscus transition.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Machine Learning Models Reliably Predict Clinical Outcomes in Medial Patellofemoral Ligament Reconstruction. 机器学习模型能可靠预测髌股内侧韧带重建术的临床效果。
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2024-08-09 DOI: 10.1016/j.arthro.2024.07.028
Hongwei Zhan, Xin Kang, Xiaobo Zhang, Yuji Zhang, Yanming Wang, Jing Yang, Kun Zhang, Jingjing Han, Zhiwei Feng, Liang Zhang, Meng Wu, Yayi Xia, Jin Jiang
{"title":"Machine Learning Models Reliably Predict Clinical Outcomes in Medial Patellofemoral Ligament Reconstruction.","authors":"Hongwei Zhan, Xin Kang, Xiaobo Zhang, Yuji Zhang, Yanming Wang, Jing Yang, Kun Zhang, Jingjing Han, Zhiwei Feng, Liang Zhang, Meng Wu, Yayi Xia, Jin Jiang","doi":"10.1016/j.arthro.2024.07.028","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.07.028","url":null,"abstract":"<p><strong>Purpose: </strong>To develop the machine learning model to predict clinical outcomes following MPFLR and identify the important predictive indicators.</p><p><strong>Methods: </strong>This study included patients who underwent MPFLR from January 2018 to December 2022. The exclusion criteria were as follows: 1) concurrent bony procedures, 2) history of other knee surgeries, and 3) follow-up period of less than 12 months. Forty-two predictive models were constructed for seven clinical outcomes (failure to achieve MCID of clinical scores, return to pre-injury sports, pivoting sports, and recurrent instability) using six machine learning algorithms (Random Forest, Logistic Regression, Support Vector Machine, Decision Tree, implemented multilayer perceptron, and K-nearest neighbor). The performance of the model was evaluated using metrics such as the area under the receiver operating characteristic curve (AUC), accuracy, specificity, and sensitivity. Additionally, Shapley Additive Explanation summary plot was employed to identify the important predictive factors of the best-performing model.</p><p><strong>Results: </strong>A total of 218 patients met criteria. For the best-performing models in predicting failure to achieve the MCID for Lysholm, IKDC, Kujala, and Tegner scores, the AUCs and accuracies were 0.884 (good) and 87.3%, 0.859 (good) and 86.2%, 0.969 (excellent) and 97.0%, and 0.760 (fair) and 76.8%, respectively; 0.952 (excellent) and 95.2% for return to pre-injury sports; 0.756 (fair) and 75.4% for return to pivoting sports; and 0.943 (excellent) and 94.9% for recurrent instability. Low preoperative Tegner score, shorter time to surgery, and absence of severe trochlear dysplasia were significant predictors for return to pre-injury sports, while absence of severe trochlear dysplasia and patellar alta were significant predictors for return to pivoting sports. Older age, female sex, and low preoperative Lysholm score were highly predictive of recurrent instability.</p><p><strong>Conclusion: </strong>The predictive models developed using machine learning algorithms can reliably forecast the clinical outcomes of MPFLR, particularly demonstrating excellent performance in predicting recurrent instability.</p><p><strong>Level of evidence: </strong>Level III, case-control study.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Preoperative Hip Injection Response Does Not Reliably Predict 2-Year Postoperative Outcomes Following Hip Arthroscopy for Femoroacetabular Impingement. 髋关节镜手术治疗股骨髋臼撞击术后两年疗效的术前髋关节注射反应并不能可靠预测。
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2024-08-09 DOI: 10.1016/j.arthro.2024.07.025
Lejla Pepic, Alexander R Markes, Hayden Sampson, Kylen K J Soriano, Stephanie E Wong, Alan L Zhang
{"title":"Preoperative Hip Injection Response Does Not Reliably Predict 2-Year Postoperative Outcomes Following Hip Arthroscopy for Femoroacetabular Impingement.","authors":"Lejla Pepic, Alexander R Markes, Hayden Sampson, Kylen K J Soriano, Stephanie E Wong, Alan L Zhang","doi":"10.1016/j.arthro.2024.07.025","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.07.025","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether response to preoperative local anesthetic or corticosteroid intra-articular injections can predict 2-year postoperative outcomes in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS).</p><p><strong>Methods: </strong>This was a retrospective analysis of patients undergoing hip arthroscopy for FAIS at a single institution from 2014-2020. Patients who underwent preoperative intra-articular hip injection were classified based on injection type (local anesthetic, corticosteroid) and whether they experienced pain relief following injection (responders, non-responders). Responders were matched 2:1 by age, BMI, and sex with non-responders. Patient reported outcomes (PROs) including Hip Disability and Osteoarthritis Outcome Score (HOOS), 12-item Short-Form Survey mental (SF-12-MCS) and physical component summary (SF-12-PCS) and visual analogue scale (VAS) pain were collected preoperatively and 2-years postoperatively. Mean score change and Minimal Clinically Important Difference (MCID) achievement were calculated and compared between groups.</p><p><strong>Results: </strong>The matched cohort included 126 total patients (42 non-responders, 84 responders; 74.6% female; mean ± SD age: 30.9 ± 9.9 years; BMI: 24.7 ± 3.7 kg/m<sup>2</sup>) with no differences in demographic or radiographic hip variables. Both groups demonstrated significant 2-year postoperative score improvements across all PROs, except SF-12-MCS, which remained unchanged. There was no difference in mean score change or MCID achievement across all PROs between corticosteroid injection responder and non-responder groups. In the local anesthetic group, MCID achievement was similar across all PROs, except VAS pain which showed greater percentage of MCID achievement among local anesthetic non-responders relative responders (Responders: 55.0%, Non-responders: 89.5%; p = 0.03). Significant ceiling effects were most readily apparent among the injection responders group with greater percentages of patients achieving maximal 2-year postoperative survey scores (36.9% HOOS-ADL, 19.0% HOOS-Pain, 15.5% HOOS-QoL, 32.1% HOOS-Sport).</p><p><strong>Conclusions: </strong>Response to preoperative injection with either corticosteroid or local anesthetic did not predict 2-year outcomes after hip arthroscopy in patients with FAIS.</p><p><strong>Level of evidence: </strong>Level III, retrospective matched cohort study.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rebound pain after arthroscopic cuff repair with interscalene brachial plexus block anesthesia is reduced by surgeon administered multimodal shoulder injections: A prospective randomized controlled trial. 外科医生进行多模式肩部注射可减少臂丛神经阻滞麻醉下关节镜袖带修复术后的反跳痛:前瞻性随机对照试验。
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2024-08-09 DOI: 10.1016/j.arthro.2024.07.029
Ki-Bong Park, Hyun-Oh Cho, Min Seok Kim, Young Dae Jeon
{"title":"Rebound pain after arthroscopic cuff repair with interscalene brachial plexus block anesthesia is reduced by surgeon administered multimodal shoulder injections: A prospective randomized controlled trial.","authors":"Ki-Bong Park, Hyun-Oh Cho, Min Seok Kim, Young Dae Jeon","doi":"10.1016/j.arthro.2024.07.029","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.07.029","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the effects of additional multimodal shoulder injections on postoperative rebound pain in patients undergoing arthroscopic rotator cuff repair (ASRCR) under interscalene brachial plexus block (ISBPB) anesthesia.</p><p><strong>Methods: </strong>A single-blind randomized controlled trial was conducted with 67 patients between April 2023 and December 2023. Patients undergoing ASRCR got an ISBPB anesthesia, not general anesthesia, were included with a minimum follow-up period of 48 h. The injection group received 40 mL of 0.75% ropivacaine, 20 mg morphine, 1:200,000 epinephrine, and saline solution, totaling 100 mL. Following surgery, the injection was administered to the subacromial space (50 ml) with blind suprascapular nerve block (25 ml) and blind axillary nerve block (25 ml). Controls received 100 mL of saline solution. Intravenous patient-controlled analgesia (IV-PCA) was used as adjuvant analgesia for all patients. The primary outcome was evaluated using the visual analog scale (VAS) pain score at 12 h after surgery, with secondary outcomes of the incidence of rebound pain and VAS pain scores at 0, 2, 4, 8, 24, 36, and 48 h postoperatively. Fentanyl in IV-PCA and rescue analgesic amounts, complications, and satisfaction were recorded.</p><p><strong>Results: </strong>Sixty-seven patients (32 in the injection group, 35 in the control group) with a mean age of 61.1±9.0 years were included. The primary outcome assessment, VAS pain score at 12 h, significantly favored the injection group (2.7±0.93 vs. 4.1±1.70, p<0.001). The incidence of rebound pain was 18.8% and 65.7% in the injection and control groups, respectively (18.8% vs 65.7%, p<0.001). The injection group reported better VAS pain scores at 24, 36, and 48 h, and lower fentanyl use over the 48 h postoperative period (p=0.014). The use of rescue analgesics was similar between groups and no complications were associated with multimodal shoulder injections. Satisfaction levels were similar in both groups.</p><p><strong>Conclusion: </strong>The present study found that multimodal shoulder injections during ASRCR under ISBPB anesthesia significantly lowered VAS pain scores at 12 hours postoperatively and reduced the incidence of rebound pain compared to the control group. Pain levels were consistently lower from 12 to 48 hours postoperatively. Additionally, the injection group had reduced opioid consumption within the first 48 hours postoperatively, with no complications observed.</p><p><strong>Level of evidence: </strong>Level I, randomized controlled trial.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long term results of hip arthroscopy for femoroacetabular impingement are similar between males and females, so let's not use sex as an excuse. 髋关节镜治疗股骨髋臼撞击症的长期效果在男性和女性之间是相似的,所以我们不要把性别作为借口。
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2024-08-09 DOI: 10.1016/j.arthro.2024.08.001
Derek Ochiai
{"title":"Long term results of hip arthroscopy for femoroacetabular impingement are similar between males and females, so let's not use sex as an excuse.","authors":"Derek Ochiai","doi":"10.1016/j.arthro.2024.08.001","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.08.001","url":null,"abstract":"<p><p>Females improve equally to males with femoroacetabular impingement syndrome arthroscopy which includes labral repair and capsular closure. The equivalence in improvement may be related to routine capsular closure in all patients. The shift from dogma to clinical certainty can only be achieved by long term outcome tracking.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Editorial Commentary: Disaggregation Should Extend to Race and Ethnicity: The Missing Pieces in the SAGER Guidelines. 分类应扩展到种族和民族:SAGER 指南中缺失的部分。
IF 4.4 1区 医学
Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2024-08-09 DOI: 10.1016/j.arthro.2024.08.002
Mark Girard Siegel
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