How periarticular corticosteroid injections impact the integrity of arthroscopic rotator cuff repair

Perdreau, Alan; Duysens, Christophe; Joudet, Thierry

doi:10.1016/j.otsr.2020.05.009

Cited by 5 publications

(10 citation statements)

References 63 publications

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“…No significant relation between pre‐operative corticosteroid injection and rotator cuff healing was indicated by the results of our study. Similar findings about the effect of corticosteroid injection on rotator cuff healing have been reported in a recent randomised controlled trial [33].…”

Section: Discussionsupporting

confidence: 88%

Older age and higher body mass index are independent risk factors for tendon healing in small- to medium-sized rotator cuff tears

Erşen

Şahin

Albayrak

2022

Knee Surg Sports Traumatol Arthrosc

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PurposeMany previous research efforts have been made to identify prognostic factors for rotator cuff healing. However, majority of these studies were conducted with heterogeneous cohorts consisted of different tear characteristics. Healing properties of a rotator cuff tear may differ depending on tear characteristics such as tear size or fatty infiltration. Therefore, studies with subgroups confined by these variables may reflect more accurate results. This study aims to investigate predictive factors for rotator cuff healing in a subgroup with small‐ to medium‐sized tears without significant fatty infiltration. MethodsThis retrospective case–control study was conducted with 94 patients with small‐ to medium‐sized rotator cuff tears. Mean age of patients was 56.0 ± 9.0 years and mean follow‐up duration was 38.3 ± 8.1 months. Post‐operative magnetic resonance imaging assessment showed that there were 75 (79.8%) successfully healed repairs and 19 (20.2%) healing failures. Age, gender, hand dominancy, body mass index (BMI), smoking habit, diabetes, corticosteroid injection, baseline clinical status, duration of surgery and biceps procedure were variables evaluated as predictive factors. ResultsBoth study groups showed significant improvement from baseline regarding clinical outcome measures (p < 0.05). However, successfully healed patients had significantly higher post‐operative functional scores and lower pain scores (p < 0.05). The univariate analysis revealed that healing was significantly affected by age (p = 0.004), BMI (p = 0.01) and diabetes (p = 0.03). In the multivariate analysis, age (p = 0.02) and BMI (p = 0.02) were found to be significant independent factors for healing. Cutoff values for oldest age and highest BMI were 63 years and 28.1 kg/m2, respectively, for a successful healing according to receiver‐operating characteristic curve analysis. ConclusionHealing failure after rotator cuff repair in small‐ to medium‐sized tears is associated with poorer outcomes. Age and BMI are independent predictive factors for healing. A successful repair is more likely in patients younger than 63 years and with BMI less than 28.1 kg/m2. Surgeons should consider this information during risk assessment, decision making and patient counselling. Level of evidenceLevel III.

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Section: Discussionsupporting

confidence: 88%

Older age and higher body mass index are independent risk factors for tendon healing in small- to medium-sized rotator cuff tears

Erşen

Şahin

Albayrak

2022

Knee Surg Sports Traumatol Arthrosc

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“…Los valores más bajos de uno a dos puntos (mejor funcionalidad) en el SST fueron los estudios que utilizaron: aumento tenodésico, tensión y cirugía abierta (24)(25)(26). El estudio que aplicó corticoesteroides intra quirúrgicamente obtuvo puntuaciones más altas de 3 a 4 post tratamiento (27).…”

Section: Desgarro Del Manguito Rotadorunclassified

“…El estudio de Young et al (2020) (28), consistió en una artroplastia reversa de hombro con o sin transferencia del dorsal ancho y redondo mayor, para fijación en el plano horizontal. La investigación además combinó puntuaciones de dos escalas diferentes: SST y DASH.…”

Section: Artropatía Glenohumeralunclassified

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Escalas de valoración de la discapacidad en el adulto mayor con patología musculoesquelética de miembro superior

Hernández Amaguaya,

Delgado Masache,

López Merino

et al. 2023

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Introducción. La investigación se trató de una revisión sistemática de la literatura científica publicada en materia de escalas que valoran la discapacidad en patología musculoesquelética de miembro superior. Objetivo. El objetivo de esta revisión fue analizar las escalas de valoración de funcionalidad y discapacidad para miembro superior en el adulto mayor. Metodología. La identificación, análisis y elaboración de resultados siguió el proceso metodológico de acuerdo con las directrices de la declaración Preferred Reporting Items for Systematic and Meta – Analyses. La estrategia de búsqueda se basó en un máximo de dos combinaciones para cada escala: “nombre de la escala” y “región corporal”, en las bases de datos científicos: PubMed, ScienceDirect y Scopus en idioma inglés. Fueron incluidos un total de 61 estudios repartidos entre las escalas: Shoulder and pain disability index, simple shoulder test, Constant-murley score. American shoulder and elbow surgeons, Oxford shoulder score, The disabilities of the arm, shoulder, and hand. Resultados. Los instrumentos analizados han sido validados y utilizados en patologías musculoesqueléticas de miembro superior en población adulta mayor en diferentes abordajes clínicos tomando en cuenta tratamientos quirúrgicos y/o conservadores. Conclusión. Los instrumentos que han sido validados y utilizados en patología musculoesquelética de miembros superiores también son útiles en adultos mayores, considerando la incidencia de las lesiones en esta población. Todas las escalas fueron utilizadas en lesiones del manguito rotador, sin embargo, su aplicabilidad dependió de criterios como: tipo de lesión, tratamiento y período de seguimiento. Área de estudio general: Rehabilitación y terapia física. Área de estudio específica: Atención temprana. Tipo de estudio: Revisión bibliográfica.

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“… 30 , 31 , 32 , 33 , 34 Corticosteroid adjuvants in periarticular analgesic injections are of interest; in fact, several clinical studies have reported a slight reduction in postoperative pain or prolongation of analgesic effect with the addition of corticosteroids to periarticular and intra-articular LA. 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 …”

Section: Introductionmentioning

confidence: 99%

Dexamethasone Does not Compensate for Local Anesthetic Cytotoxic Effects on Tenocytes: Morphine or Morphine Plus Dexamethasone May Be a Safe Alternative

Oeyen¹,

Kircher²,

Vogl

et al. 2022

Arthroscopy, Sports Medicine, and Rehabilitation

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How periarticular corticosteroid injections impact the integrity of arthroscopic rotator cuff repair

Cited by 5 publications

References 63 publications

Older age and higher body mass index are independent risk factors for tendon healing in small- to medium-sized rotator cuff tears

Older age and higher body mass index are independent risk factors for tendon healing in small- to medium-sized rotator cuff tears

Escalas de valoración de la discapacidad en el adulto mayor con patología musculoesquelética de miembro superior

Dexamethasone Does not Compensate for Local Anesthetic Cytotoxic Effects on Tenocytes: Morphine or Morphine Plus Dexamethasone May Be a Safe Alternative

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