Capito Nicholas M, Cook James L, Yahuaca Bernardo, Capito Marie D, Sherman Seth L, Smith Matthew J
Champion Orthopedics, Augusta, GA, USA.
Department of Orthopaedics, University of Missouri-Columbia, Columbia, MO, USA.
J Shoulder Elbow Surg. 2017 May;26(5):745-751. doi: 10.1016/j.jse.2017.02.021. Epub 2017 Mar 18.
A hyperosmolar irrigation solution has been reported to be safe and have potential benefits for use during shoulder arthroscopy in an animal model study. In this study, the clinical effects of a hyperosmolar solution were compared with a standard isotonic solution when used for shoulder arthroscopy.
A prospective, double-blind, randomized controlled trial was performed to compare isotonic (273 mOsm/L) and hyperosmolar (593 mOsm/L) irrigation solutions used for arthroscopic rotator cuff repair. Primary outcomes focused on the amount of periarticular fluid retention based on net weight gain, change in shoulder girth, and pain. All patients were tracked through standard postsurgical follow-up to ensure no additional complications arose. Patients were contacted at 1 year to assess American Shoulder and Elbow Surgeon score, visual analog scale pain score, and the Single Assessment Numeric Evaluation shoulder scores RESULTS: Fifty patients (n = 25/group) were enrolled and completed the study. No statistically significant differences were noted between cohorts in demographics or surgical variables. The hyperosmolar group experienced significantly less mean weight gain (1.6 ± 0.82 kg vs. 2.25 ± 0.77 kg; P = .005), significantly less change in shoulder girth (P < .05), and a significantly lower immediate postoperative visual analog scale pain score (P = .036). At 1 year postoperatively, the differences between groups for American Shoulder and Elbow Surgeons, visual analog scale pain, and Single Assessment Numeric Evaluation were not significant (P > .2).
A hyperosmolar irrigation solution provides a safe and effective way to decrease periarticular fluid retention associated with arthroscopic rotator cuff surgery without any adverse long-term effects. Use of a hyperosmolar irrigation solution for shoulder arthroscopy has potential clinical benefits to surgeons and patients.
在一项动物模型研究中，据报道高渗冲洗液在肩关节镜检查期间使用是安全的且具有潜在益处。在本研究中，比较了高渗溶液与标准等渗溶液用于肩关节镜检查时的临床效果。
进行了一项前瞻性、双盲、随机对照试验，以比较用于关节镜下肩袖修复的等渗（273 mOsm/L）和高渗（593 mOsm/L）冲洗液。主要结局指标集中在基于体重净增加、肩围变化和疼痛的关节周围液体潴留量。所有患者均通过标准术后随访进行跟踪，以确保没有出现额外并发症。在1年时联系患者，以评估美国肩肘外科医师评分、视觉模拟量表疼痛评分和单评估数字评价肩部评分。结果：招募了50名患者（每组n = 25）并完成了研究。两组在人口统计学或手术变量方面未观察到统计学上的显著差异。高渗组的平均体重增加明显较少（1.6±0.82 kg对2.25±0.77 kg；P = 0.005），肩围变化明显较小（P < 0.05），术后即刻视觉模拟量表疼痛评分明显较低（P = 0.036）。术后1年，两组在美国肩肘外科医师评分、视觉模拟量表疼痛评分和单评估数字评价方面的差异不显著（P > 0.2）。
高渗冲洗液提供了一种安全有效的方法来减少与关节镜下肩袖手术相关的关节周围液体潴留，且没有任何不良长期影响。在肩关节镜检查中使用高渗冲洗液对外科医生和患者具有潜在的临床益处。
