Purpose: This randomized noninferiority trial aimed to evaluate whether combined suprascapular, axillary nerve, and the articular branch of lateral pectoral nerve block (3NB) is noninferior to interscalene nerve block (ISB) for pain control after arthroscopic rotator cuff repair (ASRCR). Materials and Methods: Eighty-five patients undergoing ASRCR were randomized to either 3NB (n = 43) or ISB (n = 42) group. We used 5 and 15 ml of 0.2% ropivacaine for each nerve in the 3NB and ISB groups, respectively. The primary outcome was the visual analog scale (VAS) pain score at 4 h postoperatively measured assessed on an 11-point scale (ranging from 0 = no pain to 10 = worst pain) that was analyzed using noninferiority testing. The secondary outcome was VAS pain scores in the recovery room and at 8, 12, 24, 36, 48, and 72 h postoperatively. Rebound pain, IV-PCA usage during 48 h, dyspnea, muscle weakness, and satisfaction were evaluated. Results: Regarding the primary outcome, the mean difference in VAS pain scores between the 3NB (2.5 ± 1.6) and ISB (2.2 ± 2.3) groups at 4 h postoperatively was 0.3, with a 95% confidence interval (CI) of −0.56 to 1.11. The upper limit of 95% CI is lower than the noninferiority margin of 1.3 ( p < 0.001). At all other time points, except in the recovery room, 3NB showed noninferior to ISB. Rebound pain, IV-PCA usage during the second 24 h, and muscle weakness were lower in the 3NB group (all p < 0.005). The satisfaction was similar in both groups ( p = 0.815). Conclusion: Combined 3NB is noninferior to ISB in terms of pain control after ASRCR; and is associated with low levels of rebound pain, IV-PCA usage, and muscle weakness. Level of evidence: Randomized controlled trial, Level I.
Purpose: To identify the incidence and characteristics of immediate substitutions of injured players that occurred during Korean professional football league matches. Methods: This study included injuries that resulted in immediate substitutions of injured players during Korean professional football league matches. The match broadcasting records were used to check the date of the match, home-away matches, the team to which players belong, the position on the field of play, and the time of injury. The match recording videos were used to evaluate the injury mechanism and the injured area. Results: In 228 matches, 66 immediate substitutions of injured players occurred, with an incidence rate of 0.3 per match. Total number of substitutions due to injuries most frequently occurred in May, with 15 substitutions in 30 matches; however, after considering the number of substitutions per match in each month, November was the most severe month with 0.53 substitutions after injuries per match. Most frequently injured players were defenders (36.4%), followed by midfielders, forwards, and goalkeepers. Immediate substitutions of injured players took place 32 times in the first half and 34 times in the second half. 51.5% of all injuries were related to collisions, and injuries to the knee and thigh accounted for 45.5% of all injuries. Conclusion: There were 66 immediate substitutions of injured players during a single season of the Korean professional football league, with 0.3 substitutions after injuries per match. To prevent and manage serious injuries that can occur during a football match, a thorough analysis of risk factors of injuries that lead to immediate substitution is required.
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