A large database study showed that patients who were given a corticosteroid injection within 6 months preceding a rotator cuff repair, possess a high risk of undergoing a revision rotator cuff surgery in the next 3 years.

“Corticosteroid injections are frequently utilized in the nonoperative management of rotator cuff tears,” researchers headed by Sophia A. Traven, MD, mentioned in the abstract they presented at a poster event at the annual meeting of the American Orthopaedic Society for Sports Medicine. “However, recent literature suggests that injections may reduce biomechanical strengths of tendons and ligaments in animal models.”

The researchers conducted a retrospective review of the MarketScan claims data from 2010 to 2014 including 4,959 patients with an ICD-9 diagnosis of a rotator cuff tear with consequent arthroscopic rotator cuff repair. They intended to evaluate the effect of shoulder injections given preoperatively on the rate of revision cuff repair after an arthroscopic rotator cuff repair, the (CPT 29827).

Multivariable logistic regression was used to analyze the odds of reoperation among groups, while observing controls for specific demographic and comorbid variables, like age and gender, tobacco use, diabetes, and the Charlson comorbidity index score.

The highest risk for revision rotator cuff repair was observed in patients who received a preoperative injection 3-6 months before the repair (odds ratio, 1.822), trailed by those who received an injection 0-3 months prior the primary repair (OR, 1.375), and those who received an injection 6-12 months before the primary repair (OR, 1.237).

“The risk of revision rotator cuff repair remains elevated for 6 months following a shoulder injection,” the researchers concluded. “Consideration should therefore be given to minimizing preoperative injections in patients who may require rotator cuff repair.”