Summary: The purpose of this study is to assess whether the results of arthroscopic shoulder decompression can be improved with a diagnostic injection of local anesthetic into the subacromial space as a definitive test to improve the results of arthroscopic subacromial decompression.

Background

Patients with subacromial impingement have difficulties with activities of daily living, particularly with overhead work and often have difficulty sleeping on their injured shoulder. Prior studies have demonstrated that arthroscopic decompression of patients with shoulder pain does not provide substantial improvement.

Hypothesis/purpose: The purpose of this study is to assess whether the results of arthroscopic shoulder decompression can be improved with a diagnostic injection of local anesthetic into the subacromial space as a definitive test to improve the results of arthroscopic subacromial decompression.

Study design: Cohort study

Methods

Four outcome scores (ASES Index, ASES Function, VAS and SANE) were assessed by patient surveys at five different time points (preoperatively, three months, six months, one year, two years).

Results

43 patients underwent shoulder decompression procedures and 90.6% were followed for at least one year. Outcomes scores with at least 1 year followup were noted. VAS scores improved from 6.0 to 3.4. ASES Index score improved from 39.9 to 66.8. ASES Function improved from 12.1 to 20.3. SANE improved from 34.9 to 64. All measures were noted to have had a statistically significant improvement which exceeded the MCID.

Conclusion

The performance of a diagnostic subacromial injection of local anesthetic substantially improves outcome following an arthroscopic subacromial decompression in patients with intact rotator cuff tendons. This additional step helps to differentiate patients who have unrelated pain which may be related to other areas and can be confused with impingement syndrome as a cause of shoulder pain.

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Minimal Clinically Important Difference (MCID) of the Oxford Shoulder Score for Arthroscopic Rotator Cuff Repair at 5 Years Post-Operatively ePoster Presentation Merrill Lee, MBBS, MRCS(Edin), SINGAPORE Khai Cheong Wong, MBChB, MRCS (Eng), SINGAPORE Gek Hsiang Lim, MSc, SINGAPORE Benjamin Fu Hong Ang, MBBS, MRCS, MMed(Orth), FRCS(Orth), SINGAPORE Jerry Chen, MBBS, MRCS(Edin), MMed(Orth), SINGAPORE Paul Chee Cheng Chang, MBBS,FRCS, SINGAPORE Denny T. T. Lie, MBBS, FRCS, FAMS, SINGAPORE
Muscle Edema of Retraction and Pseudo Fatty Infiltration After Traumatic Rotator Cuff Tears as an Experimental Model in Sheep ePoster Presentation Tiago Martinho, MD, SWITZERLAND Joe Chih-Hao Chiu, MD, PhD, TAIWAN Marko Nabergoj, MD, SLOVENIA Sean W.L. Ho, MBBS, MRCS, MMed (Ortho), FRCS (Ortho), SINGAPORE Hugo Bothorel, MEng, SWITZERLAND Alexandre Lädermann, MD, SWITZERLAND
Superior Capsule Reconstruction with Long Head of the Biceps Tendon for Massive Irreparable Rotator Cuff Tears ePoster Presentation Marco Adriani, MD, ITALY Marcello Motta, MD, ITALY Francesco DeFilippo, MD, ITALY Alessandro Colosio, MD, ITALY Maristella Francesca Saccomanno, MD, PhD, ITALY Giuseppe Milano, Prof., ITALY
Tenodesis of Long Head of Biceps Tendon Does Not Affect Outcome after Rotator Cuff Reconstruction ePoster Presentation Mirco Sgroi, MD, GERMANY Thomas Kappe, MD, Prof., GERMANY Thomas Caffard, MD, GERMANY Marius Ludwig, MD, GERMANY Heiko Reichel, Prof., GERMANY
Efficacy of MRI Imaging Versus Reports On Surgical Decision Making In the Shoulder ePoster Presentation Maciej J K Simon, MD, PhD, GERMANY William Regan, MD FRCSc, CANADA
Efficacy of Marrow-Stimulating Technique Through Nanofractures of the Greater Tuberosity in Arthroscopic Rotator Cuff Repair ePoster Presentation Francesco De Filippo, MD, ITALY Marco Adriani, MD, ITALY Marcello Motta, MD, ITALY Giuseppe Bertoni, MD, ITALY Maristella Francesca Saccomanno, MD, PhD, ITALY Giuseppe Milano, Prof., ITALY
Evaluated The Effective Of Tendon Healing After Rotator Cuff Repair Used Modified Mason-Allen Suture Technique Combined With Microfracture Procedure ePoster Presentation Quyet Tran, MD, VIETNAM Viet Duc Vu, MD, VIETNAM Trần Trung Dũng, Professor, MD, PhD, VIETNAM
Impact of Patient Resilience on Rotator Cuff Repair Post-Operative Outcomes ePoster Presentation Ryan W. Paul, BS, UNITED STATES Michael P Campbell, MD, UNITED STATES Sydney Streicher, BA, UNITED STATES Matthew P Wallingford, BS, UNITED STATES Taylor D'Amore, MD, UNITED STATES Sean Bryan, MD, UNITED STATES Fotios P. Tjoumakaris, MD, UNITED STATES Kevin Freedman, MD, UNITED STATES

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A Diagnostic Subacromial Injection of Local Anesthetic Significantly Improves the Efficacy of Arthroscopic Shoulder Subacromial Decompression

A Diagnostic Subacromial Injection of Local Anesthetic Significantly Improves the Efficacy of Arthroscopic Shoulder Subacromial Decompression

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Methods

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A Diagnostic Subacromial Injection of Local Anesthetic Significantly Improves the Efficacy of Arthroscopic Shoulder Subacromial Decompression

A Diagnostic Subacromial Injection of Local Anesthetic Significantly Improves the Efficacy of Arthroscopic Shoulder Subacromial Decompression

Background

Methods

Results

Conclusion

More 2023 ISAKOS Congress Content