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.
Keywords: Epinephrine; Repair; Rotator cuff; Shoulder arthroscopy; Visualization.
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