Do nonsteroidal anti‐inflammatory drugs affect the outcome of arthroscopic Bankart repair?

Abstract

To achieve pain control after arthroscopic shoulder surgery, nonsteroidal anti-inflammatory drugs (NSAIDs) are a complement to other analgesics. However, experimental studies have raised concerns that these drugs may have a detrimental effect on soft tissue-to-bone healing and, thus, have a negative effect on the outcome. We wanted to investigate if there are any differences in the clinical outcome after the arthroscopic Bankart procedure for patients who received NSAIDs prescription compared with those who did not. 477 patients with a primary arthroscopic Bankart procedure were identified in the Norwegian shoulder instability register and included in the study. 32.5% received prescription of NSAIDs post-operatively. 370 (78%) of the patients answered a follow-up questionnaire containing the Western Ontario Shoulder Instability index (WOSI). Mean follow-up was 21 months. WOSI at follow-up were 75% in the NSAID group and 74% in the control group. 12% of the patients in the NSAID group and 14% in the control group reported recurrence of instability. The reoperation rate was 5% in both groups. There were no statistically significant differences between the groups. Prescription of short-term post-operative NSAID treatment in the post-operative period did not influence on the functional outcome after arthroscopic Bankart procedures.

Effects of Perioperative Nonsteroidal Anti-inflammatory Drug Administration on Soft Tissue Healing: A Systematic Review of Clinical Outcomes After Sports Medicine Orthopaedic Surgery Procedures

“…Ultimately, we identified 4 studies on the effects of perioperative NSAIDs on healing after sports medicine procedures in humans. 3,21,22,24…”

“…Among the studies included, 4 procedures were identified: 93% (4144/4451) of patients underwent anterior cruciate ligament (ACL) reconstruction, 24 3% (120/4451) underwent rotator cuff repair, 21 3% (155/4451) underwent Bankart shoulder repair, 3 and 1% (32/4451) underwent meniscal repair. 22 The type of NSAID administered was reported in 3 of 4 studies (Table 2).…”

“…Oh et al 21 compared celecoxib (200 mg twice a day) versus ibuprofen (385 mg 3 times a day) administered for 14 days after treatment. Blomquist et al 3 did not report the specific NSAID used or the dosage but noted that the NSAID was administered for an interval ranging from 1 to 7 days postoperatively.…”

“…All studies noted the length of NSAID treatment. 3,21,22,24 Proffen et al 22 delivered a dosage of ketorolac that was adjusted to patients’ body weight, ranging from 7.5 to 60 mg, either intraoperatively or in the postanesthesia care unit for patients undergoing meniscal repair. Soreide et al 24 delivered diclofenac, ketorolac, celecoxib, or another NSAID for a mean length of treatment of 6.7 days in patients undergoing ACL reconstruction.…”

“…The secondary outcomes of our study included identifying the procedures performed and their objective outcome scores to assess soft tissue healing rates. The level of evidence for each article was reported according to Wright et al 28 Of the 4 studies included, 3 studies 3,22,24 were retrospective reviews with matched cohorts, providing level 3 evidence. The remaining study 21 was described as a level 1 randomized controlled trial.…”