Subacromial Injection of Tranexamic Acid Combined with Ropivacaine Versus Ropivacaine Alone to Enhance Outcomes After Arthroscopic Rotator Cuff Repair: a Randomized Controlled Trial

INTERVENTION: Active Comparator Drug,Active Comparator Drug Subacromial Tranexamic Acid and Ropivacaine Injection after Arthroscopic Rotator Cuff Repair 0.75% Ropivacaine Hydrochloride(7.5 mg/ml) 10 ml with Tranexamic acid (50 mg/1 ml) 5ml,Subacromial Ropivacaine Injection after Arthroscopic Rotator Cuff Repair 0.75% Ropivacaine Hydrochloride(7.5 mg/ml) 10 ml with Normal saline 5 ml total 15 ml Tranexamic Acid and Ropivacaine group, Ropivacaine group CONDITION: Effecte of Subacromial Injection of Tranexamic Acid Combined with Ropivacaine Versus Ropivacaine Alone to Enhance pain and functional score outcome after Arthroscopic Rotator Cuff Repair ; Rotator Cuff Injuries, Rotator Cuff/surgery, Arthroscopy, Arthroscopic Surgical Procedures, Tranexamic Acid, Ropivacaine, Shoulder, Joint Pain, Postoperative; Treatment Outcome, Recovery of Function, Shoulder Pain, Analgesia, Local Anesthetics, Anti‐Fibrinolytic Agents, Postoperative Care, Range of Motion, Articular, Quality of Life, Randomized Controlled Trials, Double‐Blind Method, Prospective Studies Rotator Cuff Injuries, Rotator Cuff/surgery, Arthroscopy, Arthroscopic Surgical Procedures, Tranexamic Acid, Ropivacaine, Shoulder, Joint Pain, Postoperative; Treatment Outcome, Recovery of Function, Shoulder Pain, Analgesia, Local Anesthetics, Anti‐Fibrinolytic Agents, Postoperative Care, Range of Motion, Articular, Quality of Life, Randomized Controlled Trials, Double‐Blind Method, Prospective Studies PRIMARY OUTCOME: Pain 24 hr Visual analog scale SECONDARY OUTCOME: Functional score 6, 12,24,52 weeks Constant‐Murley score (CMS), Thai version of ASES, INCLUSION CRITERIA: 1. Adults aged 18 to 80 years, 2. Patients diagnosed with a partial‐thickness or full‐thickness rotator cuff tear,3. confirmed by magnetic resonance imaging , 4. indicated for arthroscopic rotator cuff repair, 5. Patients who are able to provide written informed consent and are willing to comply with the postoperative rehabilitation protocol specified in this study, 6. Rotator cuff tears meeting one of the following criteria 1.Partial‐thickness tears from Ellman Grade 1 tears that have failed conservative treatment, or Grade 2 or Grade 3 tears according to the Ellman classification. Full‐thickness tears from Small, medium, or large tears classified according to the DeOrio and Cofield classification.