Summary

Preoperative corticosteroid injections resulted in pain alleviation and improvement in ROM after arthroscopic rotator cuff repair, causing negligible adverse effects on the structural and functional outcomes at a mean three-year follow-up.

Abstract

Background

Corticosteroid injections are effective in alleviating pain in patients with rotator cuff tears, but controversy still exists regarding their potential adverse effects on clinical outcomes after rotator cuff repair.

Purpose

To compare both the functional and structural outcomes in patients who underwent arthroscopic rotator cuff repair with or without preoperative corticosteroid injections.
Study Design: Cohort study; Level of evidence: 3.

Methods

A retrospective cohort study was carried out among patients who underwent arthroscopic rotator cuff repair for partial- and full-thickness tears between 2015 and 2019. The patients who received preoperative corticosteroid injections (CSIs) were included in CSI group and compared to the group matched with tear size, age and follow-up time at a ratio of 2:1 without preoperative CSIs (non-CSI group). Both functional evaluation and structural assessments using magnetic resonance imaging (MRI) were performed at the final follow-up. Clinical outcomes including retear rate as the primary outcome, pain, functional score including Constant-Murley score, American Shoulder and Elbow Surgeons score, and Fudan University Shoulder Score, range of motion (ROM), tendon integrity, tendon healing type and cartilage thickness were compared between the two groups with statistical significance of P < .05 and power at .9.

Results

A total of 31 patients were included in the CSI group and 62 were included in the non-CSI group. After a mean three-year follow-up, the two groups demonstrated no significant differences in retear rate, visual analog scale for pain, shoulder functional scores and active ROM including forward flexion, abduction, external rotation, and internal rotation. No significant differences were observed in postoperative MRI of the rotator cuff tendon (tendon integrity, healing type, residual tendon attachment area, etc.), cartilage thickness and muscle atrophy.

Conclusions

No significant differences were found at a mean three-year follow-up in the retear rates, pain, range of motion and glenohumeral structure on postoperative MRI after arthroscopic rotator cuff repair with or without preoperative corticosteroid injections.