Safety and efficacy of hyperosmolar irrigation solution in shoulder arthroscopy JOURNAL OF SHOULDER AND ELBOW SURGERY Capito, N. M., Cook, J. L., Yahuaca, B., Capito, M. D., Sherman, S. L., Smith, M. J. 2017; 26 (5): 745–51

Abstract

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??.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.

View details for DOI 10.1016/j.jse.2017.02.021

View details for Web of Science ID 000402464300010

View details for PubMedID 28318850