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Evaluation of Hyperosmolar Irrigation Solution for Shoulder Arthroscopy: A Prospective, Double-blind, Randomized, Controlled Study

      Introduction

      A hyperosmolar irrigation fluid has been reported to be safe and have potential benefits for use during shoulder arthroscopy in a pre-clinical translational animal model study. The present study was designed to compare the clinical effects of a hyperosmolar solution to a standard isotonic solution with respect to periarticular fluid retention based on net weight gain and change in shoulder girth, as well as associated pain, after shoulder arthroscopy.

      Methods

      Under IRB approval, a prospective, double-blind, randomized, controlled trial was performed to compare isotonic (LR, 273mOsm/L) and hyperosmolar (593mOsm/L) irrigation solutions used for arthroscopic rotator cuff repair surgeries. Patients scheduled for arthroscopic rotator cuff repair who consented to participation were enrolled and then randomized into one of the two groups: Isotonic Control or Hyperosmolar. Patient demographics were recorded pre-operatively, operative data were captured, and net weight gain, change in shoulder girth, and immediate post-operative pain scores were determined and compared between groups.

      Results

      Fifty patients (n = 25/group) were enrolled and completed the study. No statistically significant differences were noted between cohorts in regards to patient demographics or surgical variables. The hyperosmolar group experienced a mean net weight gain of 3.52±1.8 lbs, which was significantly (p = 0.005) less than that of the control group (4.97±1.7 lbs). The hyperosmolar group had significantly (p < 0.05) less change in shoulder girth compared to controls. In regards to VAS pain score, patients in the hyperosmolar irrigation group reported significantly lower immediate post-operative pain (p = 0.036) compared to controls.

      Conclusion

      Based on our results, a hyperosmolar irrigation solution provides a safe and effective way to decrease periarticular fluid retention and minimize immediate postoperative pain associated with arthroscopic rotator cuff repairs. Therefore, use of a hyperosmolar irrigation solution for shoulder arthroscopy has potential clinical benefits to surgeons and patients.