Research Conducted at University of Virginia Has Updated Our Knowledge about Arthroscopy (Increasing Numbers of Shoulder Corticosteroid Injections Within a Year Preoperatively May Be Associated With a Higher Rate of Subsequent Revision Rotator …)

By a News Reporter-Staff News Editor at Managed Care Weekly Digest -- New research on Surgical Procedures - Arthroscopy is the subject of a report. According to news reporting out of Charlottesville, Virginia, by NewsRx editors, research stated, "To identify any dose-dependent association between the use of subacromial corticosteroid injections within a year before rotator cuff repair (RCR) and subsequent need for revision rotator cuff surgery. Two large administrative databases were queried for patients undergoing arthroscopic RCR."

Our news journalists obtained a quote from the research from the University of Virginia, "A minimum of 1 year of preoperative database exposure and 2 years of postoperative database follow-up were required for inclusion. Patients were stratified into groups that received 0 (control), 1, 2, or 3 or more ipsilateral corticosteroid shoulder injections within the year prior to RCR. The outcome of interest was ipsilateral revision arthroscopic or open RCR or arthroscopic debridement for a diagnosis of rotator cuff tear within 2 years of the index surgery. Revision rates were compared between groups using a multivariate logistic regression analysis controlling for demographic and comorbidity confounders. A total of 110,567 patients from the Medicare database and 12,892 patients from the private insurance database were included. There was no association between a single injection within the year prior to RCR and revision surgery in either cohort. The use of 2 or more injections was associated with a significant increase in the risk of requiring revision surgery in both the Medicare (odds ratio [OR], 2.76-3.26; P< .0001) and private insurance (OR, 2.53-2.87; P< .0001) populations. A single shoulder injection within a year prior to arthroscopic RCR was not associated with any increased risk of revision surgery; however, the administration of 2 or more injections was associated with a substantially increased risk of subsequent revision rotator cuff surgery (OR, 2.53-3.26)."

According to the news editors, the research concluded: "Although causality cannot be established on the basis of this database review, caution is recommended when considering more than 1 shoulder corticosteroid injection in patients with potentially repairable rotator cuff tears."

For more information on this research see: Increasing Numbers of Shoulder Corticosteroid Injections Within a Year Preoperatively May Be Associated With a Higher Rate of Subsequent Revision Rotator Cuff Surgery. Arthroscopy-The Journal of Arthroscopic and Related Surgery, 2019;35(1):45-50. Arthroscopy-The Journal of Arthroscopic and Related Surgery can be contacted at: W B Saunders Co-Elsevier Inc, 1600 John F Kennedy Boulevard, Ste 1800, Philadelphia, PA 19103-2899, USA (see also Surgical Procedures - Arthroscopy).

Our news journalists report that additional information may be obtained by contacting B.C. Werner, University of Virginia, Dept. of Orthoped Surg, Charlottesville, VA 22908, United States. Additional authors for this research include C.L. Camp, V. Boddapati, J.S. Dines, S.F. Brockmeier and V.S. Desai.

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