New research presented at the Specialty Day for the American Orthopaedic Society for Sports Medicine, has revealed cortisone injections pose an increased risk of rotator cuff surgery revision.
It was discovered that patients who receive cortisone injections within six months of the surgery, were more likely to require a revision surgery in the future. The researchers now suggest surgeons either avoid using the injections, or delay surgery in light of the findings.
How are cortisone injections used to treat the shoulder?
Cortisone injections are a popular treatment for shoulder injuries, often used in combination with rehabilitation. They’re typically used as a potential alternative to surgery. Shoulder surgery is known to have a long recovery period, especially rotator cuff surgery. So, the injections are used by surgeons in an attempt to prevent the need for surgery.
However, in a lot of cases, cortisone injections alone do not prevent the need for surgery. Many patients, therefore, end up requiring surgery within six months of having the injections. However, as this new research from the Medical University of South Carolina shows, these injections can potentially increase the risk of revision surgeries.
Understanding the new shoulder research
The research led by Sophia A. Traven, studied 4,959 patients who had undergone an arthroscopic primary rotator cuff repair. It was discovered 553 of the patients ended up needing a further operation. Out of these 553 patients, 70.9% of them required a revision rotator cuff repair.
Interestingly, patients who had been given cortisone injections within six months of their shoulder surgery, showed to have an increased risk of requiring revision surgery within three years. Patients who received cortisone injections between 6 and 12 months before the surgery showed no increased risk.
Researchers believe the results of the study prove there is a time-dependant relationship between revision surgery and cortisone injections. This could prove crucial to surgeons looking to improve the outlook of shoulder surgery.
Although the research is certainly interesting, the team have stated more research is now required to look into the issue further. They plan to research whether the type of injection matters, and whether or not the number of injections a patient has, can have an impact on the healing process.
Other factors which contribute to failed rotator cuff surgery
Rotator cuff surgery is known to have a higher failure rate than other types of shoulder surgery. It is generally performed as a last resort, but it does prove a largely effective solution when all other methods have failed.
There are numerous reasons a rotator cuff repair can fail. Patients over the age of 55 are known to be at an increased risk. The size of the tear or whether more than one tendon is affected will also determine the chance of success. Smoking, poor overall health and poor muscle or tendon health are also risk factors to be addressed.
Overall, this new research is promising for surgeons, as it could help to reduce the risk of revision surgery. However, other factors will still need to be considered when deciding appropriate treatment.