Cortisone Injections and the Risk for Revision of Rotator Cuff Repair
Cortisone injections are a common non-surgical approach to treating rotator cuff injuries. However, research presented at the American Orthopaedic Society for Sports Medicine’s Specialty Day in New Orleans suggests that individuals who receive injections less than 6 months before a rotator cuff repair may have an increased risk for a revision procedure.
“As more patients elect to undergo a rotator cuff repair, surgeons may want to consider either delaying surgery or avoiding shoulder injections within 6 months to lower the risk of requiring a subsequent, revision rotator cuff repair,” said lead researcher, Sophia A. Traven, MD from the Medical University of South Carolina in Charleston.
Using claims data of privately insured patients in the MarketScan database, Dr. Traven and her colleagues conducted a retrospective analysis of 4959 patients who had undergone arthroscopic primary rotator cuff repair in 2011. Of these patients, 553 required re-operation (arthroplasty or arthroscopy) within 3 years of the index procedure; 392 surgeries (70.9%) were for a revision rotator cuff repair. The mean age of those patients was 49.2 years, and 53.6% were male.
The researchers found that patients who had received an injection within 6 months of surgery were at a much higher risk of revision cuff repair within 3 years than those who had an injection between 6 and 12 months before surgery. There was no increased risk for revision rotator cuff repair for patients undergoing cortisone injection 6 to 12 months before surgery compared with patients who did not have an injection in the year preceding surgery.
“Our study is the first to demonstrate that there is a time-dependent relationship between shoulder injections and the risk of requiring a revision rotator cuff repair,” Dr. Traven said. “Additional research on how the type of injection and number of injections affect healing will be critical and help influence better recovery rates and treatment protocol.”
Traver SA, Brinton DL, Simpson KN, Adkins Z, Althoff A, Palsis JA, Ashford W, Stone H. Shoulder Injection Prior to Rotator Cuff Repair Is Associated with Increased Risk of Subsequent Surgery (Paper 06). Presented at the 2018 American Orthopaedic Society for Sports Medicine/Arthroscopy Association of North America Specialty Day, March 10, 2018, in New Orleans.