Intra-articular injection of steroids in the early postoperative period does not have an adverse effect on the clinical outcomes and the re-tear rate after arthroscopic rotator cuff repair.
PURPOSE
The purpose of this study was to compare clinical outcomes and structural integrity following arthroscopic rotator cuff repair, either with intra-articular injection of corticosteroids in the early postoperative period using ultrasound guidance or without it.


METHODS
This study included 318 patients who underwent arthroscopic repair for either a partial-thickness or small-to-medium-sized full-thickness rotator cuff tear from 2012 to 2015. Patients were divided into two groups based on the administration of an intra-articular corticosteroids injection at 3 months after the surgery: group A (with corticosteroid injection, n = 56) and group B (without corticosteroid injection, n = 262). Functional outcomes were evaluated using the visual analog scale (VAS) pain score, subjective shoulder value (SSV), American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) shoulder score, and active range of motion (ROM). Postoperative magnetic resonance arthrography (MRA) was performed 6 months postoperatively to assess structural integrity.


RESULTS
At the 2-year follow-up, both groups showed no significant differences in VAS pain score (group A/B, 1.1 ± 0.9/1.1 ± 1.1), functional scores including SSV (88.5 ± 10.8/88.3 ± 10.0), ASES (90.8 ± 6.6/90.4 ± 6.9), and UCLA scores (30.2 ± 5.6/30.7 ± 5.2), and active ROM including forward flexion (151° ± 8°/153° ± 7°), external rotation (54° ± 5°/55° ± 7°), and internal rotation (10 ± 1/10 ± 2). Follow-up MRA imaging collected 6 months after surgery showed no significant difference in the re-tear rate (n.s.) between group A and B (n = 10/56, 17.9% and 45/262, 17.2%, respectively).


CONCLUSIONS
Intra-articular corticosteroids injection in the early postoperative period after arthroscopic rotator cuff repair provided satisfactory pain relief and ROM improvement without increasing the re-tear rate or deteriorating clinical outcomes at the 2-year follow-up.


LEVEL OF EVIDENCE
III.
['Lee|Wonyong|W|', 'Kim|Sung-Jae|SJ|', 'Choi|Chong-Hyuk|CH|', 'Choi|Yun-Rak|YR|', 'Chun|Yong-Min|YM|http://orcid.org/0000-0002-8147-6136']
D001182:Arthroscopy D005260:Female D005500:Follow-Up Studies D005938:Glucocorticoids D006801:Humans D007270:Injections, Intra-Articular D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D010149:Pain, Postoperative D011182:Postoperative Care D016059:Range of Motion, Articular D012008:Recurrence D012189:Retrospective Studies D000070636:Rotator Cuff Injuries D014221:Triamcinolone D064232:Visual Analog Scale
Intra-articular injection Re-tear Corticosteroid Rotator cuff tear