Literature DB >> 30980117

Intra-articular injection of steroids in the early postoperative period does not have an adverse effect on the clinical outcomes and the re-tear rate after arthroscopic rotator cuff repair.

Wonyong Lee1, Sung-Jae Kim1, Chong-Hyuk Choi1, Yun-Rak Choi1, Yong-Min Chun2.   

Abstract

PURPOSE: The purpose of this study was to compare clinical outcomes and structural integrity following arthroscopic rotator cuff repair, either with intra-articular injection of corticosteroids in the early postoperative period using ultrasound guidance or without it.
METHODS: This study included 318 patients who underwent arthroscopic repair for either a partial-thickness or small-to-medium-sized full-thickness rotator cuff tear from 2012 to 2015. Patients were divided into two groups based on the administration of an intra-articular corticosteroids injection at 3 months after the surgery: group A (with corticosteroid injection, n = 56) and group B (without corticosteroid injection, n = 262). Functional outcomes were evaluated using the visual analog scale (VAS) pain score, subjective shoulder value (SSV), American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) shoulder score, and active range of motion (ROM). Postoperative magnetic resonance arthrography (MRA) was performed 6 months postoperatively to assess structural integrity.
RESULTS: At the 2-year follow-up, both groups showed no significant differences in VAS pain score (group A/B, 1.1 ± 0.9/1.1 ± 1.1), functional scores including SSV (88.5 ± 10.8/88.3 ± 10.0), ASES (90.8 ± 6.6/90.4 ± 6.9), and UCLA scores (30.2 ± 5.6/30.7 ± 5.2), and active ROM including forward flexion (151° ± 8°/153° ± 7°), external rotation (54° ± 5°/55° ± 7°), and internal rotation (10 ± 1/10 ± 2). Follow-up MRA imaging collected 6 months after surgery showed no significant difference in the re-tear rate (n.s.) between group A and B (n = 10/56, 17.9% and 45/262, 17.2%, respectively).
CONCLUSIONS: Intra-articular corticosteroids injection in the early postoperative period after arthroscopic rotator cuff repair provided satisfactory pain relief and ROM improvement without increasing the re-tear rate or deteriorating clinical outcomes at the 2-year follow-up. LEVEL OF EVIDENCE: III.

Entities:  

Keywords:  Corticosteroid; Intra-articular injection; Re-tear; Rotator cuff tear

Mesh:

Substances:

Year:  2019        PMID: 30980117     DOI: 10.1007/s00167-019-05486-3

Source DB:  PubMed          Journal:  Knee Surg Sports Traumatol Arthrosc        ISSN: 0942-2056            Impact factor:   4.342


  34 in total

1.  The effect of corticosteroid on collagen expression in injured rotator cuff tendon.

Authors:  Anthony S Wei; John J Callaci; Dainius Juknelis; Guido Marra; Pietro Tonino; Kevin B Freedman; Frederick H Wezeman
Journal:  J Bone Joint Surg Am       Date:  2006-06       Impact factor: 5.284

2.  Methicillin-resistant Staphylococcus aureus infection of the subacromial bursa: an unusual complication following subacromial corticosteroid injection (a report of two cases).

Authors:  Kar H Teoh; Sian A Jones; Subramaniam Gurunaidu; Mark G Pritchard
Journal:  Shoulder Elbow       Date:  2014-10-30

3.  Subacromial and intra-articular morphine versus bupivacaine after shoulder arthroscopy.

Authors:  James F Scoggin; Gerald Mayfield; Darin J Awaya; Michael Pi; Jerry Prentiss; Jayme Takahashi
Journal:  Arthroscopy       Date:  2002 May-Jun       Impact factor: 4.772

4.  An Intra-articular Steroid Injection at 6 Weeks Postoperatively for Shoulder Stiffness After Arthroscopic Rotator Cuff Repair Does Not Affect Repair Integrity.

Authors:  In-Bo Kim; Dong Wook Jung
Journal:  Am J Sports Med       Date:  2018-06-20       Impact factor: 6.202

Review 5.  Corticosteroid injection for adhesive capsulitis in primary care: a systematic review of randomised clinical trials.

Authors:  Kim Hwee Koh
Journal:  Singapore Med J       Date:  2016-08-29       Impact factor: 1.858

6.  Rotator cuff defect healing: a biomechanical and histologic analysis in an animal model.

Authors:  J E Carpenter; S Thomopoulos; C L Flanagan; C M DeBano; L J Soslowsky
Journal:  J Shoulder Elbow Surg       Date:  1998 Nov-Dec       Impact factor: 3.019

7.  Effect of a single subacromial prednisolone injection in acute rotator cuff tears in a rat model.

Authors:  Hyo-Jin Lee; Yang-Soo Kim; Ji-Hoon Ok; Yun-Kyoung Lee; Michelle Y Ha
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2013-01-31       Impact factor: 4.342

8.  Efficacy of a Subacromial Corticosteroid Injection for Persistent Pain After Arthroscopic Rotator Cuff Repair.

Authors:  Sang-Jin Shin; Nam-Hoon Do; Juyeob Lee; Young-Won Ko
Journal:  Am J Sports Med       Date:  2016-06-07       Impact factor: 6.202

9.  Optimal dose of intra-articular corticosteroids for adhesive capsulitis: a randomized, triple-blind, placebo-controlled trial.

Authors:  Seung-Hyun Yoon; Hyun Young Lee; Hyun Jung Lee; Kyu-Sung Kwack
Journal:  Am J Sports Med       Date:  2013-03-18       Impact factor: 6.202

10.  Polymicrobial anaerobic infection with a deep abscess in the supraspinous fossa following a subacromial corticosteroid injection.

Authors:  John G Skedros; Marshall K Henrie; Ethan D Finlinson; Joel D Trachtenberg
Journal:  BMJ Case Rep       Date:  2018-11-28
View more
  3 in total

1.  Clinical and structural outcome of intra-articular steroid injection for early stiffness after arthroscopic rotator cuff repair.

Authors:  Su Cheol Kim; Il Su Kim; Sang Soo Shin; Sung Woo Hong; Sang Hyeon Lee; Jae Chul Yoo
Journal:  Int Orthop       Date:  2022-01-31       Impact factor: 3.075

Review 2.  Advances in Stem Cell Therapies for Rotator Cuff Injuries.

Authors:  Hao-Nan Wang; Xiao Rong; Lu-Ming Yang; Wei-Zhong Hua; Guo-Xin Ni
Journal:  Front Bioeng Biotechnol       Date:  2022-05-25

Review 3.  Corticosteroid Injections After Rotator Cuff Repair Improve Function, Reduce Pain, and Are Safe: A Systematic Review.

Authors:  Richard N Puzzitiello; Bhavik H Patel; Ophelie Lavoie-Gagne; Yining Lu; Benedict U Nwachukwu; Brian Forsythe; Matthew J Salzler
Journal:  Arthrosc Sports Med Rehabil       Date:  2021-12-20
  3 in total

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