scholarly journals Effects of Perioperative Nonsteroidal Anti-inflammatory Drug Administration on Soft Tissue Healing: A Systematic Review of Clinical Outcomes After Sports Medicine Orthopaedic Surgery Procedures

2019 ◽  
Vol 7 (4) ◽  
pp. 232596711983887 ◽  
Author(s):  
David S. Constantinescu ◽  
Michael P. Campbell ◽  
Gilbert Moatshe ◽  
Alexander R. Vap
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Meniscal Repair ◽  
Inclusion Criteria ◽  
Soft Tissue Healing ◽  
Tissue Healing ◽  
Surgical Failure ◽  
Cuff Repair

Background: The effects of perioperative nonsteroidal anti-inflammatory drugs (NSAIDs) on soft tissue healing in humans have yet to be established. Purpose: To systematically review the literature addressing the effects of perioperative NSAID administration on soft tissue healing and clinical patient outcomes. Study Design: Systematic review; Level of evidence, 3. Methods: This review study was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. A review of the literature regarding the existing evidence for clinical effects of NSAID use on soft tissue healing was performed through use of the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed (1980 to present), and MEDLINE. Inclusion criteria for articles were as follows: outcome studies after soft tissue (ligament, meniscus, tendon, muscle) healing after surgical procedure with perioperative NSAID administration, at least 1 year of follow-up, English language, and human participants. Results: A total of 466 studies were initially retrieved, with 4 studies satisfying all inclusion criteria. Among the surgical procedures reported, 93% of the patients (4144/4451) underwent anterior cruciate ligament (ACL) reconstruction, 3% (120/4451) underwent rotator cuff repair, 3% (155/4451) underwent Bankart shoulder repair, and 1% (32/4451) underwent meniscal repair. The reported surgical failure rate among patients administered NSAIDs was 3.6% (157/4360). The reported surgical failure rate among control participants not given NSAIDs was 3.7% (147/3996). NSAID use showed no statistically significant effect on need for reoperation in meniscal repair ( P = .99), ACL reconstruction ( P = .8), and Bankart repair ( P = .8) compared with no NSAID administration. Celecoxib administration had a significantly higher rate of retear (37%) after rotator cuff repair compared with ibuprofen (7%) ( P = .009). Conclusion: Insufficient data are available to definitively state the effects of perioperative NSAIDs on soft tissue healing. Use of NSAIDs should be considered on a case-by-case basis and may not affect healing rates following either meniscal, ACL, rotator cuff, or Bankart repair. However, celecoxib (a selective COX-2 inhibitor) may inhibit tendon-to-bone healing in rotator cuff repair. Further research through clinical trials is required to fully determine whether NSAIDs have an adverse effect on soft tissue healing.

scholarly journals Effect of Platelet-Rich Plasma and Amniotic Membrane in Patients with Rotator Cuff Repair

2018 ◽  
Vol 39 ◽  
pp. 98-102
Author(s):  
Heri Suroto ◽  
Ameria Pribadi ◽  
Dwikora Novembri Utomo ◽  
Ferdiansyah Mahyudin ◽  
Lukas Widhiyanto
Keyword(s):  
Soft Tissue ◽  
Rotator Cuff ◽  
Pain Score ◽  
Amniotic Membrane ◽  
Rotator Cuff Repair ◽  
Platelet Rich Plasma ◽  
Soft Tissue Healing ◽  
Disability Score ◽  
Tissue Healing ◽  
Cuff Repair

Rotator cuff disorders are the most common source of shoulder problems, ranging from mild strain to massive tears. Platelet-rich plasma (PRP), an autologous blood with platelets concentration above baseline values represents a source of multiple growth factors that promotes tissue repair. This review examines the potential of using PRP to augment rotator cuff repair. Reporting 4 patients with impingement syndrome and supraspinatus tear who underwent decompression acromioplasty and supraspinatus repair augmented with platelet-rich plasma and amniotic membrane. An evaluation was made 3-24 months postoperative using Shoulder Pain and Disability Index (SPADI). Average preoperative pain score is 64%, disability score 54.58%, and total score 58.19%. Average postoperative pain score is 0%, disability score 0.42%, and total score 0.26% (Minimum Detectable Change at 90% confidence for pain score is 18%, disability score 13%, and total score 11%). This result is consequent with research by Luoay Fallouh, stating that improvement is caused by growth factor effects in platelet-rich plasma which promotes soft tissue healing. It can be concluded that platelet-rich plasma and amniotic membrane have promising effects to enhance soft tissue healing in patients with rotator cuff syndrome. Shoulder function is restored with no limitation on daily activity and pain is no longer present.

scholarly journals Patients With Diabetes Mellitus Have a Higher Risk of Tendon Retear After Arthroscopic Rotator Cuff Repair: A Meta-analysis

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712096140 ◽  
Author(s):  
Chih-Kai Hong ◽  
Chao-Jui Chang ◽  
Fa-Chuan Kuan ◽  
Kai-Lan Hsu ◽  
Yueh Chen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
English Language ◽  
Arthroscopic Rotator Cuff Repair ◽  
Inclusion Criteria ◽  
Level Of Evidence ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Background: Retear of a repaired rotator cuff tendon is a major issue for shoulder surgeons. It is possible that diabetes mellitus (DM) is associated with a greater risk of tendon retear after arthroscopic rotator cuff repair. Purpose: To determine whether patients with DM have a higher tendon retear risk after arthroscopic rotator cuff repair. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the Web of Science, PubMed, and Embase databases. Inclusion criteria were articles written in the English language that included patients undergoing arthroscopic rotator cuff repair surgeries, reported the numbers of patients with and those without DM, and reported the number of rotator cuff retears. Data relevant to this study were extracted and statistically analyzed. Random-effects models were used to generate pooled odds ratio estimates and CIs. Results: A total of 160 studies were identified from the initial search, and 5 of them met the inclusion criteria. A total of 1065 patients (207 patients with DM and 858 patients without DM) were included. The pooled results showed that the patients in the DM group had a significantly higher tendon retear risk than did those in the non-DM group (relative risk, 2.25; 95% CI, 1.14-4.45; P = .02). Conclusion: Patients with DM have a 2.25 times higher risk of tendon retear after arthroscopic rotator cuff repair compared with patients without DM.

Cement augmentation of suture anchors in the proximal humerus during rotator cuff repair improves pullout strength: a systematic review

2021 ◽  
pp. jisakos-2020-000603
Author(s):  
Jeff S Kimball ◽  
Anirudh K Gowd ◽  
Brian R Waterman ◽  
Seth L Sherman ◽  
Jorge Chahla ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Proximal Humerus ◽  
Cement Augmentation ◽  
Suture Anchors ◽  
Inclusion Criteria ◽  
Pullout Strength ◽  
Pullout Force ◽  
Cuff Repair

ImportanceRotator cuff pathology is a growing concern in the ageing population. If cement augmentation of suture anchors improves pullout strength, its application can potentially be applied in cases of poor bone quality to prevent anchor failure.ObjectiveTo evaluate the biomechanical benefits and fixation strength of cement-augmented versus non-augmented suture anchors in the proximal humerus during rotator cuff repair (RCR).Evidence reviewA systematic review of PubMed, Embase and Cochrane Library was performed to identify all published articles reporting on biomechanical analysis of suture anchors in the shoulder in a cadaveric model. Inclusion criteria required fresh-frozen specimens, placement in the footprint of the proximal humerus, and comparative assessment of fixation constructs with or without polymethylmethacrylate (PMMA) or bioabsorbable composite cement augmentation. Biomechanical testing procedure, cement augmentation method and pullout force were assessed.FindingsAfter review of 105 abstracts, seven full manuscripts met inclusion criteria. Six of seven studies reported statistically significant differences in mean pullout force between augmented (three PMMAs, three composites, one PMMA vs composite) and non-augmented anchors. Of two studies evaluating cycles to failure, both found a significant increase in the augmented versus non-augmented anchors. Of two studies stratifying by anchor position, both investigations identified significant differences in mean pullout strength between augmented and non-augmented anchors at the posteromedial and anterolateral anchor positions.Conclusions and relevanceCement augmentation of suture anchors in cadaveric humeri for RCR improves pullout strength regardless of cement type used or anchor position. Cement augmentation may provide a viable option for future clinical application.Level of evidenceIV, systematic review.

No difference between tenotomy vs tenodesis for the long head of the biceps tendinopathy in rotator cuff repair: a systematic review

2017 ◽  
Vol 2 (2) ◽  
pp. 89-96
Author(s):  
Nicola Maffulli ◽  
Rocco Papalia ◽  
Guglielmo Torre ◽  
Sebastiano Vasta ◽  
Giuseppe Papalia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Long Head ◽  
Cuff Repair

Return to Work After Primary Rotator Cuff Repair: A Systematic Review and Meta-analysis

2021 ◽  
pp. 036354652097542
Author(s):  
Eric D. Haunschild ◽  
Ron Gilat ◽  
Ophelie Lavoie-Gagne ◽  
Michael C. Fu ◽  
Tracy Tauro ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Return To Work ◽  
Rotator Cuff Repair ◽  
Meta Analysis ◽  
Work Outcomes ◽  
Workers Compensation ◽  
Work Intensity ◽  
Rates Of Return ◽  
Cuff Repair

Background: Rotator cuff tears are a prevalent pathology in injured workers, causing significant economic ramifications and time away from work. To date, published articles on work outcomes after rotator cuff repair have not been cumulatively assessed and analyzed. Purpose: To systematically review reports on return to work after rotator cuff repair and perform a meta-analysis on factors associated with improved work outcomes. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: A systematic review of return-to-work investigations was performed using PubMed, Embase, and the Cochrane Database of Systematic Reviews in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Individual studies reporting rates of return to previous work with level of evidence 1 to 4 were independently screened by 2 authors for inclusion, and study quality was assessed using the Methodologic Index for Non-randomized Studies and Newcastle-Ottawa Scale. Work outcome data were synthesized and analyzed using random effects modeling to identify differences in rates of return to previous work as a function of operative technique, work intensity, and workers’ compensation status. Results: Thirteen retrospective investigations comprising 1224 patients who underwent rotator cuff repair met inclusion criteria for this investigation. Across all investigations, a weighted average of 62.3% of patients returned to previous level of work at 8.15 ± 2.7 months (mean ± SD) after surgery. Based on random effects modeling, higher rates of return to previous work were identified with decreasing work intensity ( P < .001), while rates were similar between open and arthroscopic repair technique ( P = .418) and between workers’ compensation and non–workers’ compensation cohorts ( P = .089). All shoulder pain and functional outcome assessments demonstrated significant improvements at final follow-up when compared with baseline across all investigations. Conclusion: The majority of injured workers undergoing rotator cuff repair return to previous work at approximately 8 months after surgery. Despite this, >35% of patients are unable to return to their previous work level after their repair procedure. Similar rates of return to work can be anticipated regardless of workers’ compensation status and operative technique, while patients in occupations with higher physical intensity experience inferior work outcomes.

Systematic Review of Arthroscopic Rotator Cuff Repair and Mini-Open Rotator Cuff Repair

2007 ◽  
Vol 89 ◽  
pp. 127-136 ◽  
Author(s):  
Shane J. Nho ◽  
Michael K. Shindle ◽  
Seth L. Sherman ◽  
Kevin B. Freedman ◽  
Stephan Lyman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair ◽  
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