Related Experiment Video
Updated: Apr 10, 2026
Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
Published on: June 6, 2025
Post-operative pain control in arthroscopic rotator cuff repairs: a prospective, double-blinded, randomized
David Gamble1, Jay R Ebert2,3, Sam Shales1,2,4
1Department of Trauma and Orthopaedic Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
Background:
Post-operative pain following arthroscopic rotator cuff repair is challenging. Peripheral nerve blocks are commonly used, but debate remains over single-shot versus continuous interscalene catheters. This trial compared early post-operative pain and opioid use with a single-shot block versus a continuous interscalene catheter.
Methods:
In this prospective, double-blinded randomized controlled trial, 45 patients undergoing arthroscopic rotator cuff repair received an interscalene catheter with an initial single-shot block. They were randomized to either a patient-controlled infusion of normal saline (control, n = 22) or low-dose anesthetic (treatment, n = 23). Visual analogue scale for pain severity (VAS-S) and frequency (VAS-F) were assessed pre-operatively, daily for the first post-operative week, and at 2, 6, and 12 weeks. Opioid consumption was recorded for one week post-operatively. Functional outcomes were measured using the Constant and Western Ontario Rotator Cuff scores, and satisfaction with the surgery was assessed at 12 weeks.
Results:
A significant interaction effect was found for VAS-S over the first week (P = .041), with the treatment group reporting significantly lower pain on day 1 (P = .011). Both groups showed significant improvement in clinical scores (P < .0001). The treatment group had a higher Constant score at 12 weeks (P = .040), though this did not reach the Minimally Clinically Important Difference. No significant difference in opioid consumption (P = .653) or satisfaction (treatment: 82%, control: 91%) was observed.
Conclusion:
Continuous interscalene catheters improved early post-operative pain without reducing opioid use. Despite these findings, careful consideration of patient needs, cost-effectiveness, and the potential complications associated with catheter use should be acknowledged in the individual patient's pain management strategy.
