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Arthroscopic rotator cuff repair (ARCR) can provide excellent clinical results for patients who fail to respond to conservative management of symptomatic rotator cuff tears. ARCR, however, can be associated with severe postoperative pain and discomfort that requires adequate analgesia. As ARCR continues to shift toward being performed as an outpatient procedure, it is incumbent on physicians and ambulatory surgical centers to provide appropriate pain relief with minimal side effects to ensure rapid recovery and safe discharge. Although intravenous and oral opioids are the cornerstone of pain management after orthopedic procedures, they are associated with drowsiness, nausea, vomiting, and increased length of hospital stay. As health care reimbursements continue to become more intimately focused on quality, patient satisfaction, and minimizing of complications, the need for adequate pain control with minimal complications will continue to be a principal focus for providers and institutions alike. We present a review of alternative modalities for pain relief after ARCR, including cryotherapy, intralesional anesthesia, nerve blockade, indwelling continuous nerve block catheters, and multimodal anesthesia. In choosing among these modalities, physicians should consider patient- and system-based factors to allow the efficient delivery of analgesia that optimizes recovery and improves patient satisfaction., (Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)

The glenohumeral joint is innately complex and comprised of both static and dynamic stabilizers. Anterior glenohumeral instability has been estimated to have an incidence of 11.2 cases per 100,000 persons and typically follows a traumatic injury. Although there are specific instances when conservative management is advocated, a majority of these patients are treated with operative stabilization. Recent advancements in arthroscopy have created a shift from the traditional open stabilization procedures towards more minimally invasive arthroscopic stabilization procedures. This comprehensive review will summarize current concepts involved in evaluating patients with anterior glenohumeral instability and specifically focus on those patients who suffer from recurrent instability.

We describe a minimally invasive procedure for removal of a distal femur locking plate using arthroscopic assistance. Using lateral accessory portals, we performed arthroscopically-assisted removal of distal locking screws. Under fluoroscopic image, proximal screws were removed from the diaphysis. The accessory lateral portal sites used to remove the distal screws were connected. Through this arthrotomy, the plate was elevated from the distal femur and removed without difficulty. With this method we were able to concomitantly visualize the intra-articular regions while accomplishing the hardware removal.