Corticosteroid Injections May Increase Retear and Revision Rates of Rotator Cuff Repair: A Systematic Review.

Autor:	Cimino AM; Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, U.S.A., Veazey GC; Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, U.S.A., McMurtrie JT; Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, U.S.A., Isbell J; Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, U.S.A., Arguello AM; Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, U.S.A., Brabston EW; Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, U.S.A., Ponce BA; Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, U.S.A., Momaya AM; Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, U.S.A. Electronic address: amit.momaya@gmail.com.
Jazyk:	angličtina
Zdroj:	Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association [Arthroscopy] 2020 Aug; Vol. 36 (8), pp. 2334-2341. Date of Electronic Publication: 2020 May 08.
DOI:	10.1016/j.arthro.2020.04.044
Abstrakt:	Purpose: To synthesize the clinical outcome data of preoperative and postoperative corticosteroid injections (CIs) and their effect on rotator cuff repairs (RCRs). Methods: A systematic review was performed to identify studies that reported the results or clinical outcomes of RCRs in patients receiving either preoperative or postoperative CIs. The searches were performed using MEDLINE, Google Scholar, and Embase, and studies were chosen following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Results: A total of 11 studies were included with data for 176,352 shoulders: 6 studies involving 175,256 shoulders with data regarding preoperative CIs, 4 studies involving 1,096 shoulders with data regarding postoperative CIs, and 1 study with 212 shoulders containing preoperative and postoperative data. Preoperative CIs were found in 3 studies to increase the risk of revision surgery when administered within 6 months (odds ratio [OR], 1.38-1.82) and up to 1 year (OR, 1.12-1.52) prior to RCR, with revision rates in 2 studies being highest when patients received 2 or more injections (OR, 2.12-3.26) in the prior year. Postoperative CIs reduced pain and improved functional outcomes in 5 studies without increasing the retear rates (5.7%-19% for CI and 14%-18.4% for control) in most studies. Conclusions: CIs provide benefit by relieving pain and improving functional outcome scores. However, repeated preoperative CIs may increase retear rates and the likelihood of revision surgery. A lower frequency of CI and longer preoperative waiting period after CI should be considered to decrease such risks. Postoperative CIs several weeks after RCR do not appear to increase retear rates. Level of Evidence: Level IV, systematic review of Level I through IV studies. (Copyright © 2020 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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