No difference in clinical outcomes and return to sport and work with use of postoperative nonsteroidal anti-inflammatory medications following primary arthroscopic glenoid labral repair.

Abstract

To compare clinical outcomes, return to activities, and rates of revision surgery following arthroscopic glenoid labral repair in patients who were prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) as part of their postoperative pain management regimen vs. those who were not. Patients aged 18-55 who underwent primary arthroscopic labral repair at a single academic institution from the years 2016-2020 were retrospectively reviewed. Patients who underwent concomitant rotator cuff repair, remplissage, or did not have a minimum 2-year postoperative follow-up were excluded. Patients who were prescribed postoperative NSAIDs were matched 1:1 to those who were not based on age, sex, body mass index, and number of suture anchors. Outcomes were assessed using the visual analog scale for pain, American Shoulder and Elbow Surgeons score, Simple Shoulder Test, Single Assessment Numeric Evaluation rating, and satisfaction. Preinjury sport and work activity information were recorded. Of the 269 eligible patients, 224 patients were included. Patients prescribed NSAIDs postoperatively had similar levels of pain (1.2 vs. 1.0, P = 0.527) and function (American Shoulder and Elbow Surgeons score: 90.8 vs. 89.9, P = 0.824; Simple Shoulder Test: 91.9 vs. 90.6, P = 0.646; Single Assessment Numeric Evaluation rating: 83.8 vs. 85.3, P = 0.550) compared to those who were not. Rates of revision surgery (2.7% vs. 0.9%, P = 0.622) and recurrent instability (5.4% vs. 8.0%, P = 0.594) were similar between NSAID and non-NSAID groups. Rates of return to sport (83.5% vs. 77.8%, P = 0.318) and return to pre-injury level (59.3% vs. 61.6%, P = 0.177) were similar between NSAID and non-NSAID groups. Prescription of postoperative NSAIDs was not associated with delayed return to sport (odds ratio: 1.47, 95% confidence interval [0.68, 3.18], P = 0.327) or return to work (odds ratio: 0.56, 95% confidence interval [0.14, 2.28], P = 0.416). Patients who were prescribed NSAIDs as part of a postoperative pain management regimen following primary arthroscopic labral repair for glenohumeral instability had similar patient-reported outcomes, revision rates, and rates of return to preinjury activities compared to those who were not prescribed NSAIDs.