Subacromial analgesia via continuous infusion catheter vs. placebo following arthroscopic shoulder surgery: a systematic review and meta-analysis of randomized trials.


BACKGROUND:Subacromial analgesia (SAA) is hypothesized to reduce pain after arthroscopic shoulder surgery by delivering a continuous infusion of local anesthetic directly to the surgical site. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of SAA vs. placebo for pain relief after arthroscopic subacromial shoulder procedures. METHODS:MEDLINE, Embase, PubMed, and the Cochrane Central Register of Controlled Trials were searched for randomized controlled trials comparing SAA with placebo after arthroscopic shoulder surgery. Outcomes collected included pain scores (converted to equivalent ordinal visual analog scores; minimal clinically important difference 1.4 cm), oral morphine equivalents used postoperatively, and catheter-related complications. Meta-analysis was performed via a random-effects model. Included trials underwent a risk of bias and quality of evidence assessment. RESULTS:Nine studies involving 459 participants were included. There were no clinically significant changes for pain scores in SAA at 6-, 12-, 24-, and 48-hour postoperative timepoints. Patients receiving SAA used less morphine equivalents of pain medication at 12 hours only (-0.37 mg, 95% confidence interval: -0.63 to -0.11), but there was no significant difference at 24 and 48 hours. There were no major complications (infection or reoperation). Included trials demonstrated a moderate risk-of-bias, and low to very low quality of evidence for primary outcomes. CONCLUSION:Subacromial continuous infusion of local anesthetic does not provide a clinically significant benefit compared with placebo as part of a multimodal analgesia regime after arthroscopic subacromial surgical procedures. Future, high-quality trials are required to further assess the efficacy of SAA against placebo.


J Shoulder Elbow Surg


An VVG,Farey JE,Karunaratne S,Smithers CJ,Petchell JF




Has Abstract


2020-03-01 00:00:00














  • Three or more preoperative injections is the most significant risk factor for revision surgery after operative treatment of lateral epicondylitis: an analysis of 3863 patients.

    abstract:BACKGROUND:This study was conducted to identify the rate of failure of operative treatment of lateral epicondylitis, defined as progression to ipsilateral revision surgery, and associated patient-specific risk factors for failure. METHODS:A national database was used to identify patients undergoing surgical treatment ...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Degen RM,Cancienne JM,Camp CL,Altchek DW,Dines JS,Werner BC

    更新日期:2017-04-01 00:00:00

  • Is radiographic measurement of acromiohumeral distance on anteroposterior view after reverse shoulder arthroplasty reliable?

    abstract:BACKGROUND:Reverse shoulder arthroplasty leads to arm lengthening. Different techniques have been described to determine postoperative lengthening. The purpose of this study was to evaluate the reliability of the acromiohumeral distance (AHD) in determining arm lengthening after reverse shoulder arthroplasty. METHODS:...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章,多中心研究


    authors: Werner BS,Jacquot A,Molé D,Walch G

    更新日期:2016-09-01 00:00:00

  • The operative outcomes of displaced medial-end clavicle fractures.

    abstract:BACKGROUND:Nonoperative treatment of displaced medial clavicle fractures often leads to poor functional outcomes and painful nonunions. This study investigates the functional outcomes of patients undergoing operative fixation of these fractures. METHODS:We investigated 27 patients undergoing operative fixation of a me...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Sidhu VS,Hermans D,Duckworth DG

    更新日期:2015-11-01 00:00:00

  • Combined pectoralis major and latissimus dorsi tendon transfer for massive rotator cuff deficiency.

    abstract::This report is a retrospective review of 11 consecutive patients treated with a combined transfer of the latissimus dorsi and pectoralis major tendons for massive rotator cuff deficiency. Each patient's chief complaint was diminished shoulder function and motion with little or no accompanying pain. The primary operati...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Aldridge JM 3rd,Atkinson TS,Mallon WJ

    更新日期:2004-11-01 00:00:00

  • A new role for orthopaedic surgeons: ongoing changes, lessons learned, and perspectives from a level I trauma center during the COVID-19 pandemic.

    abstract::The COVID-19 pandemic has redefined global health care. With almost 13 million confirmed cases worldwide, medical professionals have been forced to modify their practice to take care of an expanded, critically ill population. Institutions have been challenged to implement innovative ways to maximize the utility and th...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章,评审


    authors: Congiusta DV,Otero K,Ippolito J,Thomson J,Beebe KS

    更新日期:2020-10-01 00:00:00

  • Comparative study of cultures and next-generation sequencing in the diagnosis of shoulder prosthetic joint infections.

    abstract:BACKGROUND:Serum and synovial markers used to diagnose lower extremity prosthetic joint infection (PJI) have performed poorly for shoulder PJI. As a result, diagnosis is commonly reliant on the accuracy of positive or negative cultures. Next-generation sequencing (NGS) can sequence an entire bacterial genome. This stud...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Namdari S,Nicholson T,Abboud J,Lazarus M,Ramsey ML,Williams G,Parvizi J

    更新日期:2019-01-01 00:00:00

  • The effect of intraarticular anesthesia and elastic bandage on elbow proprioception.

    abstract::Twenty uninjured male volunteers were studied to characterize normal elbow proprioception and to investigate the effect of applying an elastic bandage to the extremity and injection of an intraarticular anesthetic. A modified Biodex dynamometer was used to study position sense and detection of motion. In part 1 of the...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Khabie V,Schwartz MC,Rokito AS,Gallagher MA,Cuomo F,Zuckerman JD

    更新日期:1998-09-01 00:00:00

  • The coracoacromial ligament: the morphology and relation to rotator cuff pathology.

    abstract::We dissected 80 shoulders from 44 fresh cadavers to define variants of the coracoacromial ligament and their relationship to rotator cuff degeneration. The shapes and the geometric data of the ligaments were investigated, and the rotator cuffs of the cadavers were evaluated macroscopically. Five main types of coracoac...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Kesmezacar H,Akgun I,Ogut T,Gokay S,Uzun I

    更新日期:2008-01-01 00:00:00

  • Rupture of the subscapularis tendon after shoulder arthroplasty: diagnosis, treatment, and outcome.

    abstract::The purpose of this study was to document the diagnosis, surgical treatment, and functional outcome in patients with subscapularis ruptures after shoulder arthroplasty. Prospective objective and subjective data were collected on 7 patients with symptomatic rupture of the subscapularis tendon after shoulder arthroplast...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Miller BS,Joseph TA,Noonan TJ,Horan MP,Hawkins RJ

    更新日期:2005-09-01 00:00:00

  • A review of national shoulder and elbow joint replacement registries.

    abstract:BACKGROUND:The aim was to review the funding, organization, data handling, outcome measurements, and findings from existing national shoulder and elbow joint replacement registries; to consider the possibility of pooling data between registries; and to consider wether a pan european registry might be feasible. MATERIA...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章,评审


    authors: Rasmussen JV,Olsen BS,Fevang BT,Furnes O,Skytta ET,Rahme H,Salomonsson B,Mohammed KD,Page RS,Carr AJ

    更新日期:2012-10-01 00:00:00

  • Nonprosthetic glenoid arthroplasty with humeral hemiarthroplasty and total shoulder arthroplasty yield similar self-assessed outcomes in the management of comparable patients with glenohumeral arthritis.

    abstract::The risk of glenoid component failure has led us to explore nonprosthetic glenoid arthroplasty coupled with humeral hemiarthroplasty, the "ream and run" (R&R) procedure, for the management of glenohumeral arthritis in active patients. We hypothesized that patients having a R&R procedure would have outcomes comparable ...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Clinton J,Franta AK,Lenters TR,Mounce D,Matsen FA 3rd

    更新日期:2007-09-01 00:00:00

  • Valgus instability of the elbow due to medial epicondyle nonunion: treatment by fragment excision and ligament repair--a report of 5 cases.

    abstract::We identified 5 patients with valgus instability of the elbow due to nonunion of a previous fracture of the medial epicondyle. There were 4 male patients and 1 female patient with a mean age of 35 years (range, 15-54 years). The original avulsion fracture of the medial epicondyle had occurred a mean of 10.1 years prev...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Gilchrist AD,McKee MD

    更新日期:2002-09-01 00:00:00

  • Implantation of a porcine acellular dermal graft in a primate model of rotator cuff repair.

    abstract:BACKGROUND:Non-cross-linked xenogeneic extracellular matrix graft materials have typically elicited a hypersensitivity reaction when implanted into humans or other primates. The purpose of this study was to examine the histologic and immune response to a non-cross-linked porcine-derived dermal extracellular matrix graf...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Xu H,Sandor M,Qi S,Lombardi J,Connor J,McQuillan DJ,Iannotti JP

    更新日期:2012-05-01 00:00:00

  • Elastic stable intramedullary nailing versus Kirschner wire pinning: outcome of severely displaced proximal humeral fractures in juvenile patients.

    abstract:BACKGROUND:Significantly displaced juvenile proximal humeral fractures (Neer-Horowitz type 3 and 4) usually require reduction and fixation. The most commonly used fixation methods are Kirschner wire (K-wire) pinning or retrograde elastic stable intramedullary nailing (ESIN). However, results comparing the long-term out...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Kraus T,Hoermann S,Ploder G,Zoetsch S,Eberl R,Singer G

    更新日期:2014-10-01 00:00:00

  • Incidence and causes of shoulder girdle injuries in an urban population.

    abstract::In a prospective population-based study of all shoulder injuries seen at Malmö General Hospital during 1987, the incidence and causes of major injuries involving fractures of the clavicle, scapula, or proximal humerus and glenohumeral or acromioclavicular dislocations were investigated in children, adults, and the eld...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Nordqvist A,Petersson CJ

    更新日期:1995-03-01 00:00:00

  • Musculocutaneous nerve entrapment revisited.

    abstract::Compression of the lateral cutaneous nerve of the forearm (LCNF), the distal sensory termination of the musculocutaneous nerve, can occur below the biceps aponeurosis, most commonly after strenuous elbow extension or forearm pronation. Between 1965 and 1992, 15 patients reported pain in the anterolateral elbow with "b...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 临床试验,杂志文章


    authors: Davidson JJ,Bassett FH 3rd,Nunley JA 2nd

    更新日期:1998-05-01 00:00:00

  • Management of radioulnar synostosis with mobilization, anconeus interposition, and a forearm rotation assist splint.

    abstract::Three cases of post-traumatic proximal radioulnar synostosis are presented. Each was treated with surgery with excision of the heterotrophic new bone and mobilization of the proximal radius. The anconeus muscle was mobilized as a vascularized pedicle graft and then interposed between the proximal radius and ulna. Two ...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Bell SN,Benger D

    更新日期:1999-11-01 00:00:00

  • Normal shoulder outcome score values in the young, active adult.

    abstract:BACKGROUND:Our objective was to determine baseline, normative values for multiple shoulder outcome scores in a young, active population without shoulder symptoms. METHODS:One hundred ninety-two volunteers completed the Single Assessment Numeric Evaluation, modified American Shoulder and Elbow Surgeons score, Western O...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Clarke MG,Dewing CB,Schroder DT,Solomon DJ,Provencher MT

    更新日期:2009-05-01 00:00:00

  • Patient outcomes after humeral fracture surgery during the COVID-19 outbreak in Spain.

    abstract:BACKGROUND:The global spread of the 2019 novel coronavirus (COVID-19) has profoundly affected the way we conduct our health care practices. The goal of this paper is to report the outcomes of 11 patients who underwent humeral fracture surgery in the first few weeks of the COVID-19 outbreak in Spain. METHODS:This was a...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Garcia-Portabella M,Nuñez JH,Batalla L,Plomer M,Lakhani K,Massons J

    更新日期:2020-08-01 00:00:00

  • In vivo 3-dimensional analysis of scapular kinematics: comparison of dominant and nondominant shoulders.

    abstract:BACKGROUND:Alterations in scapular motion frequently are seen in association with various shoulder disorders. It is common clinically to compare the pathological shoulder with the contralateral shoulder, in spite of arm dominance, to characterize the disorder. However, there have been few articles that test the underly...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Matsuki K,Matsuki KO,Mu S,Yamaguchi S,Ochiai N,Sasho T,Sugaya H,Toyone T,Wada Y,Takahashi K,Banks SA

    更新日期:2011-06-01 00:00:00

  • Coronal plane radiographic evaluation of the single TightRope technique in the treatment of acute acromioclavicular joint injury.

    abstract:BACKGROUND:This study aimed to demonstrate the technical aspects of the single TightRope (Arthrex, Naples, FL, USA) procedure for acute acromioclavicular-coracoclavicular joint dislocation, identify the predictive factors influencing its outcome, and assess and validate the significance of specific radiologic parameter...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Yi Y,Kim JW

    更新日期:2015-10-01 00:00:00

  • Glenoid deformity in the coronal plane correlates with humeral head changes in osteoarthritis: a radiographic analysis.

    abstract:BACKGROUND:A variety of measurements can be used to assess radiographic osteoarthritic changes of the shoulder. This study aimed to analyze the correlation between the radiographic humeral-sided Samilson and Prieto classification system and 3 different radiographic classifications describing the changes of the glenoid ...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Hawi N,Magosch P,Tauber M,Lichtenberg S,Martetschläger F,Habermeyer P

    更新日期:2017-02-01 00:00:00

  • A proposal for classification of the superior transverse scapular ligament: variable morphology and its potential influence on suprascapular nerve entrapment.

    abstract:BACKGROUND:The suprascapular region is the most common site of suprascapular nerve entrapment. The aim of the present study was to determine the morphologic variation of the superior transverse scapular ligament (STSL) and measure the reduction in size of the suprascapular opening. Other structures that might be potent...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Polguj M,Jędrzejewski K,Podgórski M,Majos A,Topol M

    更新日期:2013-09-01 00:00:00

  • Large coronal shear fractures of the capitellum and trochlea treated with headless compression screws.

    abstract:BACKGROUND:The purpose of this study is to retrospectively evaluate the clinical outcomes of 18 patients with large coronal shear fractures of the capitellum and lateral trochlea that underwent open reduction and internal fixation with headless compression screws. METHODS:Eighteen patients were identified (16 women, 2...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Mighell M,Virani NA,Shannon R,Echols EL Jr,Badman BL,Keating CJ

    更新日期:2010-01-01 00:00:00

  • Angular stable fixation of displaced distal-third clavicle fractures with superior precontoured locking plates.

    abstract:HYPOTHESIS:We reviewed the outcome of angular stable plates in addressing displaced lateral-third clavicle fractures. We investigated union, shoulder function, request for implant removal, and return to sport. Our hypothesis was that these implants provide predictable union and return to sports without the negative con...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Fleming MA,Dachs R,Maqungo S,du Plessis JP,Vrettos BC,Roche SJ

    更新日期:2015-05-01 00:00:00

  • Traumatic recurrent anterior dislocation of the shoulder: two- to four-year follow-up of an anatomic open procedure.

    abstract::The purpose of this study was to evaluate the results of an anatomic open stabilization procedure. Twenty-three consecutive patients with traumatic, recurrent, anterior glenohumeral instability were managed with a modified open procedure. All had a Bankart lesion. A standardized, true anatomic capsulolabral reconstruc...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Jolles BM,Pelet S,Farron A

    更新日期:2004-01-01 00:00:00

  • After rotator cuff repair, stiffness--but not the loss in range of motion--increased transiently for immobilized shoulders in a rat model.

    abstract::Although rotator cuff repair is often successful at relieving pain, the repaired insertion site frequently fails. Mechanical properties of the repair improved when the shoulder was immobilized in an animal model, but joint stiffness and range of motion were not evaluated. The objective of this study was to measure rot...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Sarver JJ,Peltz CD,Dourte L,Reddy S,Williams GR,Soslowsky LJ

    更新日期:2008-01-01 00:00:00

  • Three-dimensional shoulder kinematics normalize after rotator cuff repair.

    abstract:BACKGROUND:Patients with a rotator cuff (RC) tear often exhibit scapular dyskinesia with increased scapular lateral rotation and decreased glenohumeral elevation with arm abduction. We hypothesized that in patients with an RC tear, scapular lateral rotation, and thus glenohumeral elevation, will be restored to normal a...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Kolk A,de Witte PB,Henseler JF,van Zwet EW,van Arkel ER,van der Zwaal P,Nelissen RG,de Groot JH

    更新日期:2016-06-01 00:00:00

  • Type E2 glenoid bone loss orientation and management with augmented implants.

    abstract:BACKGROUND:The purpose of this study was 2-fold: (1) to quantify type E2 bone loss orientation and its association with rotator cuff fatty infiltration and (2) to examine reverse baseplate designs used to manage type E2 glenoids. METHODS:Computed tomography scans of 40 patients with type E2 glenoids were examined for ...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Abdic S,Knowles NK,Walch G,Johnson JA,Athwal GS

    更新日期:2020-07-01 00:00:00

  • Anterior and anterior-inferior shoulder instability: Treatment by glenoid labrum reconstruction and a modified capsular shift procedure.

    abstract::An anterior glenoid labrum reconstruction in conjunction with a modified anterior-inferior capsular shift is described and was performed in 64 patients (69 shoulders) with traumatic anterior or anterior-inferior glenohumeral instability. Sixty-three operations were performed for recurrent dislocation and six for recur...

    journal_title:Journal of shoulder and elbow surgery

    pub_type: 杂志文章


    authors: Paulos LE,Evans IK,Pinkowski JL

    更新日期:1993-11-01 00:00:00