The use of opioid pain medication regimens to control perioperative pain has led to significant patient and societal consequences. There are several alternative, opioid-sparing and opioid-minimizing pain regimens that have been shown to provide equal, if not superior, pain relief with fewer secondary consequences. This article provides an in-depth review of the current evidence regarding efficacy, safety, and feasibility of a perioperative opioid-sparing clinical pathway for patients undergoing shoulder arthroplasty.
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http://dx.doi.org/10.1016/j.ocl.2023.04.005 | DOI Listing |
J Shoulder Elbow Surg
January 2025
Massachusetts General Hospital, Department of Orthopedic Surgery. Boston, MA, USA.
Background: Painful degeneration of the sternoclavicular joint refractory to nonoperative treatment has historically been managed with resection of the degenerative segment of the medial clavicle. Although this has produced good results with improvement in symptoms, recurrent pain necessitating revision surgery is not an infrequently encountered outcome. To reduce the occurrence of recurrent postoperative pain, a novel technique to reconstruct the intra-articular disc at the time of medial clavicle resection was developed.
View Article and Find Full Text PDFBone Jt Open
January 2025
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Aims: The aim of this study was to report long-term clinical outcomes of a modern convertible metal-backed glenoid (MBG) in total shoulder arthroplasty (TSA).
Methods: After a minimum of 15 years, a previously studied cohort of 35 patients who received a modern convertible MBG during the period 1996 to 2005 was contacted for clinical and radiological follow-up. At last follow-up, patients were evaluated radiologically and clinically according to the Constant Score, Simple Shoulder Test, and visual analogue scale for pain.
Cureus
December 2024
Trauma and Orthopedics, Medway Maritime Hospital, Gillingham, GBR.
Rotator cuff tears in the shoulder joint are common musculoskeletal injuries that may present with or without symptoms. Rotator cuff tears are a common musculoskeletal condition that become increasingly prevalent with age. This mines various surgical interventions for rotator cuff tears, focusing on patient selection criteria and treatment outcomes across different subgroups.
View Article and Find Full Text PDFEssential amino acid (EAA) supplementation, including conditionally essential amino acid (CEAA) and branched-chain amino acids (BCAA) supplementation, has been suggested as a mechanism to optimize patient outcomes by counteracting the atrophy associated with orthopedic procedures. We sought to investigate the effect of EAA supplementation in the perioperative period on patients undergoing orthopedic and spine surgery, specifically whether it is associated with (1) reductions in postoperative muscle atrophy and (2) improved postoperative function including range of motion, strength, and mobility. We conducted a systematic review of the literature.
View Article and Find Full Text PDFJ Orthop
July 2025
Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Background: Anatomic total shoulder arthroplasty (aTSA) is often delayed due to concerns about a more rapid loss of postoperative improvements in younger, more active patients. This retrospective study investigated the effects of patient age on activity-specific functional outcomes at a minimum of 10 years following aTSA.
Methods: A retrospective review of a shoulder arthroplasty database was performed.
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