Portal-site epinephrine injections improve visualisation in arthroscopic rotator cuff repair.

OBJECTIVES

The aim of this study was to evaluate if portal-site injections of 1:200,000 epinephrine improve intraoperative visualisation in arthroscopic rotator cuff repair.

METHODS

Patients with partial-thickness supraspinatus tears were selected for the study. They were assigned consecutive numbers and were divided into two groups-control group and intervention group. The surgeries were done by a single surgeon. Every odd-numbered patient was injected. Johnson's visibility classification, surgeon 5-point ordinal Likert scale (LS), and other parameters were recorded.

RESULTS

A total of 221 participants (58.4 ​± ​6.1 years) were selected. Intraoperative visibility was better in the intervention group according to Johnson's classification-satisfactory visibility was achieved in 68 of 110 patients (62%, control group) compared to 89 of 111 patients (80%) (p ​= ​0.003). Surgeon LS was superior in the intervention group, with a notable decrease in worsened visibility cases. The operative time did not alter statistically significantly-82.2 ​± ​14.4 ​min for the control group, compared to 80.9 ​± ​10.8 ​min in the intervention group (p ​= ​0.056). No injection-associated complications were recorded.

CONCLUSIONS

Portal-site injection of diluted epinephrine solution is safe and improves intraoperative visualisation in arthroscopic rotator cuff repair. This addition does not increase operative time.

LEVEL OF EVIDENCE: Level 3, case-control study.