Portal-site epinephrine injections improve visualization 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 visualization 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 versus intervention group. The surgeries were done by a single surgeon. Every odd patient (number) was injected. Johnson's visibility classification, surgeon 5-point ordinal Likert scale (LS), and other parameters were recorded.

RESULTS: 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 68/110 patients (62%, control group) compared to 89/111 patients (80%) (p=0.003). Surgeon LS was superior in the intervention group with a notable decrease in worsened visibility cases. Operative time did not alter statistically significant - 82.2 ±14.4 minutes for the control group compared to 80.9 ±10.8 minutes 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 visualization in arthroscopic rotator cuff repair. This addition does not increase operative time.

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