Non-selective NSAIDs do not increase retear rates post-arthroscopic rotator cuff repair: A meta-analysis

Area of Science:

• Orthopedic Surgery
• Pain Management
• Pharmacology

Background:

• Arthroscopic rotator cuff repair (RCR) necessitates effective post-operative pain management for optimal patient outcomes.
• Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently used for pain relief and to reduce opioid dependence.
• Concerns exist regarding NSAIDs' potential impact on tendon healing after RCR, necessitating further investigation.

Purpose of the Study:

• To investigate the effect of NSAIDs on retear rates following arthroscopic rotator cuff repair.
• To evaluate the impact of NSAIDs on clinical outcomes, including pain and shoulder function, post-RCR.
• To clarify the safety and efficacy of NSAIDs in the context of arthroscopic rotator cuff repair.

Main Methods:

• A systematic literature search was performed across four major databases (PubMed, EMBASE, Scopus, Cochrane Library).
• Studies comparing post-RCR NSAID use versus control groups were included for meta-analysis.
• Retear rates, Visual Analogue Scale (VAS) pain scores, and American Shoulder and Elbow Surgeons (ASES) scores were analyzed.

Main Results:

• Six studies comprising 916 patients (443 NSAID group, 473 control) were included in the meta-analysis.
• No significant differences were observed in retear rates (p=0.70) or functional outcomes (VAS, ASES scores) between NSAID and control groups.
• Subgroup analysis indicated a significant difference in retear rates concerning selective COX-2 inhibitors versus non-selective NSAIDs (p<0.01).

Conclusions:

• NSAID use following arthroscopic rotator cuff repair is not associated with increased retear rates.
• NSAIDs can be utilized for post-RCR pain management, offering clinical outcomes comparable to non-NSAID regimens.
• Further research into specific NSAID types, such as selective COX-2 inhibitors, may be warranted.