Summary

Patients who had received an injection within 6 months prior to rotator cuff repair were much more likely to undergo a revision cuff repair within the following 3 years

Abstract

Introduction

Corticosteroid injections (CSI) are frequently utilized in the nonoperative management of rotator cuff tears. However, recent literature suggests that injections may reduce biomechanical strength of tendons and ligaments in animal models. The goal of this study was to determine if the timing of preoperative shoulder injections are associated with an increased risk of revision rotator cuff repair following primary rotator cuff repair (RCR).

Methods

A retrospective analysis of claims data of privately-insured subjects from the MarketScan® database for the years 2010-2014 was conducted. Multivariable logistic regression models were used to compare the odds of reoperation between groups. Laterality for the injection, index procedure, and subsequent surgery was verified for all subjects.

Results

A total of 4,959 subjects with an arthroscopic RCR were identified, 392 of which required revision RCR within the following 3 years. Patients who had an injection within 6 months preceding the index surgery were at a much higher risk of undergoing reoperation for revision RCR: 0-3 months prior, adjusted odds ratio (AOR) 1.375 (95% CI: 1.027-1.840); 3-6 months, AOR 1.822 (95% CI: 1.290-2.573); and 6-12 months AOR 1.237 (95% CI: 0.787-1.943).

CONCULSIONS: Patients who had received an injection within 6 months prior to RCR were much more likely to undergo a revision cuff repair within the following 3 years. The risk of reoperation significantly declines if there is more than 6 months between injection and RCR. Consideration should therefore be given to minimizing preoperative injections in patients requiring RCR or delaying primary rotator cuff repair for 6 months following injection.