36Patellar Tendon Ruptures in Weight Lifters After Local Steroid Injections
Archives of Orthopaedic and Trauma Surgery (2009) · Shen-Kai Chen, Cheng-Chang Lu, Pei-His Chou, Lan-Yuen Guo, Wen-Lan Wu
This retrospective study examined seven weight lifters who experienced patellar tendon ruptures following multiple local corticosteroid injections. All patients had a history of receiving steroid injections directly into the patellar tendon. The study found a strong association between repeated steroid injections and the incidence of tendon rupture. Surgical intervention within 72 hours led to favorable outcomes, with most athletes returning to weightlifting within 18 months. The authors concluded that multiple local steroid injections are a significant risk factor for patellar tendon rupture, particularly in athletes.
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85Corticosteroid Injections Help Short Term but Worsen Outcomes Long Term
Lancet (2010) · Coombes BK, Bisset L, Vicenzino B
This systematic review of 41 randomized controlled trials with 2,672 participants evaluated the clinical efficacy and safety of injection therapies for tendinopathy. The study found that corticosteroid injections reduced pain in the short term (within 4 weeks) compared to other interventions, showing a large effect size. However, this benefit was reversed at intermediate term (13 to 26 weeks) and long term (52 weeks and beyond). For example, in treating lateral epicondylalgia (tennis elbow), corticosteroid injections showed a large positive effect in the short term but actually performed worse than no intervention at all by the intermediate and long-term follow-up. This means that patients who received corticosteroid injections were ultimately worse off than if they had done nothing. The study also found that the short-term efficacy for rotator cuff tendinopathy was not clear. Among 991 participants who received corticosteroid injections, one case of tendon rupture was reported. These findings demonstrate that while corticosteroid injections provide temporary pain relief, they do not support long-term healing and may actually delay recovery. The reversal of benefit over time is consistent with the concern that pain masking leads to further tissue damage, as patients overuse the injured area while unable to feel the warning signs of strain.
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