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December 31, 2020
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Ibuprofen led to less opioid use after arthroscopic rotator cuff repair

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Patients who received ibuprofen required less opiate medication 1 week after arthroscopic rotator cuff repair, but had similar pain scores at 6 weeks compared with patients who received placebo, according to a recent study.

Perspective from Matthew J. DiPaola, MD

Jennifer Tangtiphaiboontana, MD, and colleagues randomly assigned 110 patients undergoing primary arthroscopic rotator cuff repair to receive ibuprofen or placebo for 2 weeks after surgery in addition to the standard opioid medication.

“Patients were instructed to keep a pain diary for the first week and to bring in their medication bottle for pill counting,” Tangtiphaiboontana said in her presentation at the American Shoulder and Elbow Surgeons Annual Meeting.

Researchers collected pre- and postoperative clinical outcomes and performed ultrasound examination at 1 year to evaluate repair integrity.

The ibuprofen group comprised 51 patients and the placebo group included 50 patients after nine patients either withdrew or were dropped due to protocol non-compliance, according to Tangtiphaiboontana. Investigators observed no differences in VAS pain scores between the two groups at 6 weeks postoperatively.

“At 6 months, the ibuprofen group had higher ASES scores and forward flexion when compared to the placebo group,” Tangtiphaiboontana said. “However, there was no difference at 1 year.”

In the first postoperative week, Tangtiphiaboontana reported the ibuprofen group consumed 43 morphine mg equivalents less vs. the placebo group. Patients in the ibuprofen group also had less pain on postoperative days 3, 4, 5 and 6, she added.

“There were 74 patients available for ultrasound examination at 1 year,” Tangtiphaiboontana said. “Seven tears were seen on ultrasound in the ibuprofen group compared to 12 in the placebo group; however, this difference was not statistically significant.”

Editor’s note: On Jan. 8, 2021, we corrected the headline and lede of this article to clarify that ibuprofen led to less opioid use 1 week after arthroscopic rotator cuff repair but had similar pain scores at 6 weeks compared with placebo. The Editors regret this error.