Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
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Arthroscopic decompression of the suprascapular nerve by transection of the transverse scapular ligament has only recently been described. Arthroscopic decompression of a bony suprascapular notch foramen has not been previously reported. This article presents a case report and outlines an arthroscopic technique to safely decompress a bony suprascapular notch. ⋯ The smooth cannula serves nicely to sweep and retract the suprascapular artery and associated fibrofatty tissue from the field of view while allowing instrumentation and visualization of the suprascapular notch. The course of the suprascapular nerve and morphology of the notch is confirmed. A Kerrison punch rongeur, routinely used in spine surgery, is introduced through the superomedial portal and a notchplasty is performed safely, allowing decompression of the suprascapular nerve.
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To perform a controlled laboratory study to evaluate the effect of bupivacaine and morphine on chondrocytes and synovium in a coculture model of diarthrodial joints. ⋯ Intra-articular bupivacaine infusion is an effective analgesic strategy and is frequently used in both office and outpatient surgical settings. This study provides evidence that the continued usage of postoperative bupivacaine continuous infusion pumps may have a detrimental effect on chondrocytes. Morphine has been shown to be an effective intra-articular analgesic, and its anti-inflammatory role seen in this study makes it a potential alternative to bupivacaine.