Injection Timing Tied to Risk for Infection in Rotator Cuff Repair
MONDAY, April 22, 2019 -- For patients undergoing arthroscopic rotator cuff repair, corticosteroid injections within the previous month are associated with an increased risk for surgical site infection, according to a study published in the April 17 issue of The Journal of Bone & Joint Surgery.
Brian Forsythe, M.D., from Rush University Medical Center in Chicago, and colleagues stratified patients undergoing arthroscopic rotator cuff repair from 2007 to 2016 into those who underwent repair within one year of corticosteroid injection (12,060 patients) and those without previous injection (48,763 patients). Patients were further stratified by the timing of the injection prior to the surgical procedure.
The researchers found that the incidence of surgical site infection did not differ significantly for patients receiving a shoulder injection versus the control cohort (0.7 versus 0.8 percent). Compared with the control group, patients receiving an injection within one month prior to operative management had a significantly higher rate of surgical site infection overall (1.3 versus 0.8 percent; odds ratio, 1.7). Independent risk factors for developing surgical site infection included male sex, obesity, diabetes, smoking status, and preoperative corticosteroid injections within one month of the surgical procedure (odds ratio, 1.7, 1.4, 1.3, 1.7, and 2.1, respectively) in multivariate analysis.
"If patients receive a corticosteroid injection to treat symptomatic rotator cuff tears, the results of this study suggest that physicians allow at least one month prior to proceeding with operative management to reduce postoperative infections," the authors write.
Two authors disclosed financial ties to the medical device industry.
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Posted: April 2019