The time of postoperative corticosteroid injection can be individualized after arthroscopic rotator cuff repair

J Orthop Sci. 2022 May;27(3):621-626. doi: 10.1016/j.jos.2021.02.010. Epub 2021 Apr 12.

Abstract

Background: Intra-articular corticosteroid injection is an effective treatment for pain and to improve the range of motion (ROM) of the shoulder joint. However, consideration of when it would be effective to inject corticosteroids after rotator cuff repair is more limited. The purpose of this study was to compare the outcomes of corticosteroids injection given at 4 and 8 weeks after arthroscopic rotator cuff repair.

Methods: Between December 2016 and January 2018, 42 patients who underwent arthroscopic supraspinatus tendon repair were enrolled. Nineteen patients received 40 mg of triamcinolone injection 4 weeks after surgery (group 1), while 23 patients received the same injection 8 weeks after surgery (group 2). Clinical outcome was evaluated using ROM, American Shoulder and Elbow Surgeons (ASES) score, Constant score, Korean Shoulder score, and a visual analog scale (VAS) score before surgery and at 3, 6, and 12 months after surgery. Tendon integrity was assessed with magnetic resonance imaging (MRI) and sonography at 12 months after surgery.

Results: Significant improvements in pain and functional scores were observed at the last follow-up in both groups (p < 0.05). There was no significant difference in VAS pain score between the two groups at any time point after surgery (p > 0.05). Functional scores and ROM in all directions also showed no statistical difference between the two groups (p > 0.05). Retears of the repaired tendon, assessed at 12 months postoperatively, were observed in two patients from group 1 (10.5%) and two patients from group 2 (8.7%), thus indicating no significant difference between the two groups (p > 0.05).

Conclusion: Since there was no significant difference in clinical outcomes and tendon integrity, postoperative corticosteroid injection can be individualized according to the patient for 4-8 weeks after the rotator cuff repair.

MeSH terms

  • Adrenal Cortex Hormones
  • Arthroscopy / methods
  • Humans
  • Injections, Intra-Articular
  • Magnetic Resonance Imaging
  • Pain
  • Range of Motion, Articular
  • Rotator Cuff / diagnostic imaging
  • Rotator Cuff / surgery
  • Rotator Cuff Injuries* / diagnostic imaging
  • Rotator Cuff Injuries* / drug therapy
  • Rotator Cuff Injuries* / surgery
  • Shoulder Joint* / surgery
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones