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The efficacy of pain relief by nerve block anesthesia for arthroscopic rotator cuff repair
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Abstracts / Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology 9 (2017) 59e124
Shoulder - Rotator cuff tear and disorder EP-269 THE EFFICACY OF PAIN RELIEF BY NERVE BLOCK ANESTHESIA FOR ARTHROSCOPIC ROTATOR CUFF REPAIR Satoshi Iwashita 1, Hiroshi Hashiguchi 2, Atsushi Okubo 2, Kazumasa Abe 2, Minoru Yoneda 1, Shinro Takai 1. 1 Department of Orthopedics, Nippon Medical School, Japan; 2 Department of Orthopedics, Nippon Medical School Chiba Hokusoh, Japan Purpose: The patients underwent arthroscopic rotator cuff repair (ARCR) get satisfactory clinical outcomes. However, many patients soon after undergoing ARCR complain of severe pain. The combination of general anesthesia and local anesthesia is effective for pain relief after upper limb surgery. Among local anesthesia, blocks are useful anesthesia technique for patients underwent ARCR. The purpose of this study was to investigate the efficacy of pain reduction by single-shot and continuous interscalenous blocks using ultrasound and suprascapular nerve block for ARCR. Methods: 40 patients underwent ARCR were the subjects of this study. They were devideded randomly into 4 groups, 11 patients were performed by continuous interscalenous block (0.25% ropivacaine) for 2 days postoperatively (CI Group), 10 patients by single interscalenous block (10 ml, 0.75% ropivacaine) preoperatively (SI Group), 8 patients by suprascapular nerve block (0.75% ropivacaine 10ml) preoperatively (SS Group) and 11 patients without block (C Group). All interscalenous blocks were performed by using ultrasound. We compared the dose of diclofenac sodium and pentazocine injection, visual analog scale (VAS) after operation, preparation time and complications between each group. VAS was measured soon after the operation, 1 and 6 hours, 1, 2, 3, 7 and 14 days postoperatively. All data were evaluated statistically by ANOVA and the significance level was set at less than 5%. Results: There was no significant difference in the dose of diclofenac sodium and pentazocine between each group. VAS was significantly lower in SI and CI group than in that of C and SS group at soon after operation, 1 and 6 hours postoperatively. VAS was significantly lower in CI group than that of SI, SS and C group at 1 day postoperatively. There was no significant difference in preparation time between each group. Temporary paralysis of fingers and leak of drug solution was found in one patient of CI group. Discussion: Both single-shot and continuous interscalenous block for pain relief were effective at the operation day. Interscalenous block using ultrasound is reliable anesthesia for patients who underwent ARCR. In addition, the continuous interscalenous block which might obtain continuous pain relief may reduce protective muscle contraction of shoulder caused by postoperative pain. Keywords: arthroscopic rotator repair, interscalenous blocks, suprascapular nerve block
recordedpreoperatively and postoperatively. Results: Follow-up was obtained in all patients, and it averaged 10.5weeks.At 12 w postoperatively, both of VAS, Constant score and FUSS performed increased significantly in all patients compared with preoperative. However, FUSS had already reached significant improvement at the8 wpostoperatively compared with 4 w (P<0.05), while for Constant scorethis happenedonly at the 12 w postoperatively. Overall, range of motion showed satisfactory resultsat final follow-up.Abduction, flexion, external rotation at 90 of abduction, internal rotation at 0 of abduction, and internal rotation at 90 of abduction recovered more rapidly within 4 weeks after surgery, however, there was no significant difference in ROM after 12weeks. Conclusions: In this broad group of patients with recalcitrant adhesive capsulitis, the combination of thesubscapularis tendon and inferior glenohumeral ligament release significantly improve patient function and ROM. Furthermore, FUSS was probably more sensitive for the early postoperative evaluation, especially for nighttime pain sensation and patient satisfaction. Keywords: frozen shoulder, subscapularis tendon
Shoulder - Rotator cuff tear and disorder EP-286 THE PRIMARY OUTCOMES OF OSTEOLYTIC LESION OF GREATER TUBEROSITY IN CALCIFIC TENDINITIS OF THE SHOULDER Ma Jia, Lei Zhang. Department of Sports Medicine, Wangjing Hospital, China Purpose: To investigated tuberosity osteolysis, an uncommon and frequently misdiagnosed form of calcific tendinitis of the shoulder, and evaluated its treatment strategy and effects on clinical outcomes. Methods: A total of 46 patients with calcific tendinitis treated by arthroscopy. 8 patients of this had an unusual “variant” of calcific tendinitis characterized by osteolytic involvement of the greater tuberosity. There were divided into groups positive and negative for tuberosity osteolysis. Follow-up evaluation was at one year, using the Constant score. Results: Tuberosity osteolysis was associated with significantly lower Constant scores. But the Constant score in patients with osteolytic involvement improved from 41±13 to 76±9 at final follow-up (P <0.001). Conclusion: Arthroscopy is an effective treatment to osteolytic lesion of greater tuberosity in calcific tendinitis of the shoulder. Functional data indicate that calcific tendinitis of the rotator cuff with tuberosity osteolysis is a distinctive form of calcific tendinitis that should be considered in clinical and surgical practice. Keywords: OSTEOLYTIC LESION, GREATER TUBEROSITY, CALCIFIC TENDINITIS
Shoulder - Rotator cuff tear and disorder
Shoulder - Rotator cuff tear and disorder
EP-277 ARTHROSCOPIC RELEASE OF SUBSCAPULARIS TENDON COMBINED WITH INFERIOR GLENOHUMERAL LIGAMENT FOR RESISTANT FROZEN SHOULDER: A RETROSPECTIVE STUDY
EP-290 AUGMENTATION OF THE LONG HEAD OF THE BICEPS TENDON FOR IRREPARABLE MASSIVE ROTATOR CUFF TEAR
Hui Qiang, Min Feng. Department of Sports Medicine, Shaanxi Provincial People's Hospital, China Purpose: With advances in arthroscopictechnique, arthroscopic release was believed to bean effective method for the recalcitrant cases resistant toconservative treatment. Regarding the extent ofrelease, however, there werevarious debates in the literature.The aims of our study were to assess effects of the extent of capsular release and to definethe benefit of combination release of the subscapularis tendon and inferior glenohumeral ligament in frozen shoulder. Methods: Forty consecutive patients with refractory frozenshoulder underwent arthroscopic capsular release. The extent of release focused on the subscapularis tendon and inferior glenohumeral ligaments (IGHL), both of the inferior and posterior. VAS, Constant functional scores and the Fudan university shoulder score (FUSS) wereused to assess the outcome. The range of motion (ROM) in various directions was also
Qiu Binsong. Department of Sports Medicine And Joint Surgery, Zhejiang Provincial People’s Hospital, China Background: Numerous operative techniques have been described for the treatment of massive rotator cuff tears with severe retraction where anatomical repair is impossible, and numerous augmentation of the long head of the biceps tendon operative techniques of have been described for the treatment of irreparable massive rotator cuff tear. But there was no very good methods to treat irreparable massive rotator cuff tear. Materials: 11 shoulders with irreparable massive rotator cuff tears treated with augmentation of the long head of biceps tendon were included for analysis. There were 4 males, 7 females, mean age was 66.7 years old. Methods: The patients were under general anesthesia. We first partially repaired the repairable portion of the rotator cuff, and then adopted the long head of the biceps tendon to repair and augment the irreparable part of the supraspinatus. The proximal attachment of the long head of the biceps tendon was preserved, and the distal part of the long head of the
Abstracts / Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology 9 (2017) 59e124
Shoulder - Rotator cuff tear and disorder EP-269 THE EFFICACY OF PAIN RELIEF BY NERVE BLOCK ANESTHESIA FOR ARTHROSCOPIC ROTATOR CUFF REPAIR Satoshi Iwashita 1, Hiroshi Hashiguchi 2, Atsushi Okubo 2, Kazumasa Abe 2, Minoru Yoneda 1, Shinro Takai 1. 1 Department of Orthopedics, Nippon Medical School, Japan; 2 Department of Orthopedics, Nippon Medical School Chiba Hokusoh, Japan Purpose: The patients underwent arthroscopic rotator cuff repair (ARCR) get satisfactory clinical outcomes. However, many patients soon after undergoing ARCR complain of severe pain. The combination of general anesthesia and local anesthesia is effective for pain relief after upper limb surgery. Among local anesthesia, blocks are useful anesthesia technique for patients underwent ARCR. The purpose of this study was to investigate the efficacy of pain reduction by single-shot and continuous interscalenous blocks using ultrasound and suprascapular nerve block for ARCR. Methods: 40 patients underwent ARCR were the subjects of this study. They were devideded randomly into 4 groups, 11 patients were performed by continuous interscalenous block (0.25% ropivacaine) for 2 days postoperatively (CI Group), 10 patients by single interscalenous block (10 ml, 0.75% ropivacaine) preoperatively (SI Group), 8 patients by suprascapular nerve block (0.75% ropivacaine 10ml) preoperatively (SS Group) and 11 patients without block (C Group). All interscalenous blocks were performed by using ultrasound. We compared the dose of diclofenac sodium and pentazocine injection, visual analog scale (VAS) after operation, preparation time and complications between each group. VAS was measured soon after the operation, 1 and 6 hours, 1, 2, 3, 7 and 14 days postoperatively. All data were evaluated statistically by ANOVA and the significance level was set at less than 5%. Results: There was no significant difference in the dose of diclofenac sodium and pentazocine between each group. VAS was significantly lower in SI and CI group than in that of C and SS group at soon after operation, 1 and 6 hours postoperatively. VAS was significantly lower in CI group than that of SI, SS and C group at 1 day postoperatively. There was no significant difference in preparation time between each group. Temporary paralysis of fingers and leak of drug solution was found in one patient of CI group. Discussion: Both single-shot and continuous interscalenous block for pain relief were effective at the operation day. Interscalenous block using ultrasound is reliable anesthesia for patients who underwent ARCR. In addition, the continuous interscalenous block which might obtain continuous pain relief may reduce protective muscle contraction of shoulder caused by postoperative pain. Keywords: arthroscopic rotator repair, interscalenous blocks, suprascapular nerve block
recordedpreoperatively and postoperatively. Results: Follow-up was obtained in all patients, and it averaged 10.5weeks.At 12 w postoperatively, both of VAS, Constant score and FUSS performed increased significantly in all patients compared with preoperative. However, FUSS had already reached significant improvement at the8 wpostoperatively compared with 4 w (P<0.05), while for Constant scorethis happenedonly at the 12 w postoperatively. Overall, range of motion showed satisfactory resultsat final follow-up.Abduction, flexion, external rotation at 90 of abduction, internal rotation at 0 of abduction, and internal rotation at 90 of abduction recovered more rapidly within 4 weeks after surgery, however, there was no significant difference in ROM after 12weeks. Conclusions: In this broad group of patients with recalcitrant adhesive capsulitis, the combination of thesubscapularis tendon and inferior glenohumeral ligament release significantly improve patient function and ROM. Furthermore, FUSS was probably more sensitive for the early postoperative evaluation, especially for nighttime pain sensation and patient satisfaction. Keywords: frozen shoulder, subscapularis tendon
Shoulder - Rotator cuff tear and disorder EP-286 THE PRIMARY OUTCOMES OF OSTEOLYTIC LESION OF GREATER TUBEROSITY IN CALCIFIC TENDINITIS OF THE SHOULDER Ma Jia, Lei Zhang. Department of Sports Medicine, Wangjing Hospital, China Purpose: To investigated tuberosity osteolysis, an uncommon and frequently misdiagnosed form of calcific tendinitis of the shoulder, and evaluated its treatment strategy and effects on clinical outcomes. Methods: A total of 46 patients with calcific tendinitis treated by arthroscopy. 8 patients of this had an unusual “variant” of calcific tendinitis characterized by osteolytic involvement of the greater tuberosity. There were divided into groups positive and negative for tuberosity osteolysis. Follow-up evaluation was at one year, using the Constant score. Results: Tuberosity osteolysis was associated with significantly lower Constant scores. But the Constant score in patients with osteolytic involvement improved from 41±13 to 76±9 at final follow-up (P <0.001). Conclusion: Arthroscopy is an effective treatment to osteolytic lesion of greater tuberosity in calcific tendinitis of the shoulder. Functional data indicate that calcific tendinitis of the rotator cuff with tuberosity osteolysis is a distinctive form of calcific tendinitis that should be considered in clinical and surgical practice. Keywords: OSTEOLYTIC LESION, GREATER TUBEROSITY, CALCIFIC TENDINITIS
Shoulder - Rotator cuff tear and disorder
Shoulder - Rotator cuff tear and disorder
EP-277 ARTHROSCOPIC RELEASE OF SUBSCAPULARIS TENDON COMBINED WITH INFERIOR GLENOHUMERAL LIGAMENT FOR RESISTANT FROZEN SHOULDER: A RETROSPECTIVE STUDY
EP-290 AUGMENTATION OF THE LONG HEAD OF THE BICEPS TENDON FOR IRREPARABLE MASSIVE ROTATOR CUFF TEAR
Hui Qiang, Min Feng. Department of Sports Medicine, Shaanxi Provincial People's Hospital, China Purpose: With advances in arthroscopictechnique, arthroscopic release was believed to bean effective method for the recalcitrant cases resistant toconservative treatment. Regarding the extent ofrelease, however, there werevarious debates in the literature.The aims of our study were to assess effects of the extent of capsular release and to definethe benefit of combination release of the subscapularis tendon and inferior glenohumeral ligament in frozen shoulder. Methods: Forty consecutive patients with refractory frozenshoulder underwent arthroscopic capsular release. The extent of release focused on the subscapularis tendon and inferior glenohumeral ligaments (IGHL), both of the inferior and posterior. VAS, Constant functional scores and the Fudan university shoulder score (FUSS) wereused to assess the outcome. The range of motion (ROM) in various directions was also
Qiu Binsong. Department of Sports Medicine And Joint Surgery, Zhejiang Provincial People’s Hospital, China Background: Numerous operative techniques have been described for the treatment of massive rotator cuff tears with severe retraction where anatomical repair is impossible, and numerous augmentation of the long head of the biceps tendon operative techniques of have been described for the treatment of irreparable massive rotator cuff tear. But there was no very good methods to treat irreparable massive rotator cuff tear. Materials: 11 shoulders with irreparable massive rotator cuff tears treated with augmentation of the long head of biceps tendon were included for analysis. There were 4 males, 7 females, mean age was 66.7 years old. Methods: The patients were under general anesthesia. We first partially repaired the repairable portion of the rotator cuff, and then adopted the long head of the biceps tendon to repair and augment the irreparable part of the supraspinatus. The proximal attachment of the long head of the biceps tendon was preserved, and the distal part of the long head of the