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Portal-site epinephrine injections improve visualisation in arthroscopic rotator cuff repair
Tsvetan Tsenkov1, Dochka Tzoneva2, Nikolay Dimitrov1
1Department of Orthopaedics and Traumatology, Medical University, Sofia 1000, Bulgaria; University Hospital of Orthopaedics "Prof. B. Boichev", Sofia 1614, Bulgaria.
Objectives:
The aim of this study was to evaluate if portal-site injections of 1:200,000 epinephrine improve intraoperative visualisation in arthroscopic rotator cuff repair.
Methods:
Patients with partial-thickness supraspinatus tears were selected for the study. They were assigned consecutive numbers and were divided into two groups-control group and intervention group. The surgeries were done by a single surgeon. Every odd-numbered patient was injected. Johnson's visibility classification, surgeon 5-point ordinal Likert scale (LS), and other parameters were recorded.
Results:
A total of 221 participants (58.4 ± 6.1 years) were selected. Intraoperative visibility was better in the intervention group according to Johnson's classification-satisfactory visibility was achieved in 68 of 110 patients (62%, control group) compared to 89 of 111 patients (80%) (p = 0.003). Surgeon LS was superior in the intervention group, with a notable decrease in worsened visibility cases. The operative time did not alter statistically significantly-82.2 ± 14.4 min for the control group, compared to 80.9 ± 10.8 min in the intervention group (p = 0.056). No injection-associated complications were recorded.
Conclusions:
Portal-site injection of diluted epinephrine solution is safe and improves intraoperative visualisation in arthroscopic rotator cuff repair. This addition does not increase operative time.
Level Of Evidence:
Level 3, case-control study.
