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Previous cortisone injections for rotator cuff tear associated with increased risk for revision surgery

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People who have cortisone injections to treat rotator cuff injuries may be more likely to require surgical revision later on, new research suggests.

In a study presented at the American Orthopaedic Society for Sports Medicine’s Specialty Day in New Orleans, researchers found that individuals who received injections less than six months before a rotator cuff repair had an increased risk of reoperation.

“As more patients elect to undergo a rotator cuff repair, surgeons may want to consider either delaying surgery or avoiding shoulder injections within six months to lower the risk of requiring a subsequent, revision rotator cuff repair,” said lead researcher Dr Sophia A. Traven, from the Medical University of South Carolina.

Traven and her team analysed data on 4,959 patients who had an arthroscopic primary rotator cuff repair in 2011. Of these subjects, 553 required reoperation within the following three years and 392, or 70.9%, were for a revision rotator cuff repair. Patients who had an injection within six months were at a much higher risk of requiring a revision cuff repair within the following three years, while those who had an injection six months to one year before surgery had no increased risk compared to those that did not have an injection at all within the year preceding surgery.

The research was undertaken after recent literature suggested that injections may reduce biomechanical strength of tendons and ligaments in animal models and increase the risk of postoperative infections following surgery.

“Our study is the first to demonstrate that there is a time-dependent relationship between shoulder injections and the risk of requiring a revision rotator cuff repair,” Dr Traven said.

Further research is needed to find out how the type of injection and number of injections affect healing, she added.