Purpose
The goal of this study was to determine whether the timing of preoperative shoulder
injections is associated with an increased risk of revision rotator cuff repair following
primary rotator cuff repair (RCR).
Methods
A retrospective analysis of claims data of privately insured subjects from the MarketScan
database for the years 2010 to 2014 was conducted. Multivariable logistic regression
models were used to compare the odds of reoperation between groups. Laterality for
the injection, index procedure, and subsequent surgery were verified for all subjects.
Results
A total of 4,959 subjects with an arthroscopic RCR were identified, 392 of whom required
revision RCR within the following 3 years. Patients who had an injection within 6 months
preceding the index surgery were at a much higher risk of undergoing reoperation for
revision RCR: 0 to 3 months prior, adjusted odds ratio (AOR) 1.375 (95% confidence
interval [CI], 1.027-1.840); 3 to 6 months prior, AOR 1.822 (95% CI, 1.290-2.573);
and 6 to 12 months prior, AOR 1.237 (95% CI, 0.787-1.943).
Conclusions
Patients who had received an injection within 6 months prior to RCR were much more
likely to undergo a revision cuff repair within the following 3 years. The risk of
reoperation significantly declines if there is more than 6 months between injection
and RCR. Consideration should be given to minimizing preoperative injections in patients
requiring RCR or delaying primary RCR for 6 months following injection.
Level of Evidence
Level III, therapeutic study.
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Article Info
Publication History
Published online: February 04, 2019
Accepted:
October 21,
2018
Received:
May 20,
2018
Footnotes
See commentary on page 714
The authors report the following potential conflicts of interest or sources of funding: This publication was partially supported by the South Carolina Clinical & Translational Research (SCTR) Institute, with an academic home at the Medical University of South Carolina, through NIH - NCATS Grant Number UL1 TR001450. Data analytic support for the study was provided through funding for the CEDAR core from the MUSC Office of the Provost. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2019 by the Arthroscopy Association of North America
