Deltoid muscle pressures during arthroscopic rotator cuff repair

The purpose of this study was to investigate deltoid compartment pressures during arthroscopic rotator cuff repair using modern pressure pumps to achieve visualization. Twelve patients undergoing arthroscopic rotator cuff repairs were monitored for deltoid compartment pressure changes intraoperatively. Pre-, intra-, and postoperative intramuscular pressures were recorded. All patients demonstrated varying degrees of swelling due to fluid extravasation. Swelling was qualified as mild, moderate, or severe by clinical assessment and quantified objectively using a pressure monitor to record deltoid compartment pressures. Clinically, severe swelling occurred in 4 patients, all of whom underwent procedures lasting longer than 90 minutes. Objectively, no patient had evidence of dangerously elevated pressure measurements. The mean increase in compartment pressures was 9 mm Hg. All patients were treated and discharged as outpatients. No patient required more than oral narcotic analgesics for postoperative pain control beyond the postanesthesia care unit stay. Arthroscopic rotator cuff repair may lead to clinically impressive swelling, but within the current study group, no evidence existed of clinically significant, persistent elevation of deltoid compartment measures using current arthroscopic techniques and arthroscopic pump systems. However, caution should be observed with regard to extended operative times and elevation of pump pressures.