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Corticosteroid Injections Before Rotator Cuff Surgery Increase Failure Rates
Full Title
Adverse Impact of Corticosteroid Injection on Rotator Cuff Tendon Health and Repair: A Systematic Review.
Summary
This systematic review assessed the adverse effects of corticosteroid injections in patients with rotator cuff disease, particularly before rotator cuff repair surgery. The review identified 8 articles reporting adverse outcomes. The findings showed that even a single corticosteroid injection was associated with an increased risk of requiring revision rotator cuff repair, with odds ratios ranging from 1.3 to 2.8 when administered up to a year before surgery. The risk of adverse outcomes was greatest when injections were administered within 6 months of surgery, with an odds ratio of 1.8. Receiving 2 or more injections within a year of surgery further increased the risk, with odds ratios ranging from 2.1 to 3.3. Corticosteroid injections within one month of surgery also increased the risk of postoperative infection, with an odds ratio of 2.1. The study demonstrates that corticosteroid injections have a temporal and dose-dependent negative effect on rotator cuff tendon health and surgical outcomes. These findings support the recommendation that corticosteroid injections should be approached with caution, particularly when surgery may be needed, and that multiple injections should be avoided. Patients should be informed of these risks and encouraged to discuss alternatives with their physician.