Liposomal bupivacaine reduces opiate consumption after rotator cuff repair in a randomized controlled trial.

Background: Arthroscopic rotator cuff repair (ARCR) provides excellent clinical outcomes but is often associated with significant postoperative pain. The use of intraoperative anesthesia in conjunction with multimodal pharmacologic strategies is a widely accepted approach for managing surgical pain and reducing opiate use. The purpose of this study was to determine whether using a combined field and suprascapular nerve block with liposomal bupivacaine (LB) in addition to an interscalene block would provide greater pain relief and a reduction in opiate consumption compared with an interscalene block alone.

Rehabilitation Strategies After Shoulder Arthroplasty in Young and Active Patients.

A well-designed and sensibly progressed rehabilitation program is vital to successful shoulder arthroplasty outcomes. This article describes the protocol suggested by ONS clinicians to treat the growing young, active patient population undergoing anatomic shoulder arthroplasty. This protocol includes an immediate postoperative phase, early strengthening phase, resistance strengthening and proprioception phase, and advanced sport-specific and goal-specific strengthening and proprioception phase.

Safety of open suprapectoral and subpectoral biceps tenodesis: an anatomic assessment of risk for neurologic injury.

Background: Surgical techniques for proximal biceps tenodesis that include penetration of the posterior humeral cortex for fixation may pose risk to the surrounding neurovascular structures.

Hypothesis: The risk of neurologic injury with techniques that involve penetration of the posterior humeral cortex for fixation in proximal biceps tenodesis will increase as the tenodesis site moves proximally from the subpectoral to the suprapectoral location.

Methods: Proximal biceps tenodesis was performed on 10 cadaveric upper extremities with 3 separate techniques.

Biomechanical evaluation of distal biceps reconstruction with cortical button and interference screw fixation.

Hypothesis: Tension slide repair maintains the strength of the standard cortical button repair but reduces gap formation at the repair. Distal biceps tendon repair with a suspensory cortical button has yielded the strongest published repair, despite observed gap formation and tendon pistoning. The tension slide technique (TST) was described to reduce gap formation while maintaining the strength of cortical button repair.

Distal biceps repair using cortical button fixation.

Various techniques have been described to repair the distal biceps tendon. The optimal technique would incorporate a limited 1-incision technique with maximal strength and minimal gapping of the repair to allow early range of motion. We describe a modified use of a cortical button, the tension-slide technique, which allows for a transverse anterior incision and the ability to tension and dock the repair through the anterior incision.