Prior Ipsilateral Steroid Injections Do Not Compromise Postoperative Outcomes or Increase Risk for Postoperative Complications or Revisions Surgery After Arthroscopic Rotator Cuff Repair

Purpose This study aimed to determine the effect of prior ipsilateral subacromial corticosteroid injection (CSI) on patient outcomes following arthroscopic rotator cuff repair. Methods A retrospective review was conducted on patients who underwent primary arthroscopic rotator cuff repair performed by a single fellowship-trained orthopedic surgeon from 2018 to 2019, utilizing single-row techniques for tears smaller than 1.5 cm and double-row techniques for tears larger than 1.5 cm.. Patients were divided into two cohorts based on whether they received a preoperative CSI within 12 months of surgery: (1) injection group (IG) and (2) control group (CG). Range of motion (ROM), patient-reported pain and satisfaction, subjective shoulder value (SSV), postoperative complications and reoperations were collected at final follow-up and compared between groups. The impact of the number of preoperative injections on outcomes was assessed by subgroup analysis based on the number of preoperative injections administered: Group 1 included one injection versus Group 2 included two or more injections. The impact of the timing of injections on outcomes was assessed by subgroup analysis based on the timing of their most recent injection: (1) ≤ 3 months before surgery, or (2) > 3 but < 12 months before surgery. Results Forty-two patients with preoperative CSIs (mean age, 60.2 years; 54.8% females) were identified and compared against 183 control patients (mean age, 58 years; 39.8% females). No significant differences in demographics between groups were found. The mean follow-up time was 12.6 months (range, 6 – 33.8 months). Preoperatively, the injection group had a significantly greater forward elevation (p=0.003), abduction (p=0.005), and active external rotation (p<0.001). No significant differences in postoperative pain, shoulder function, shoulder strength, ROM, or SSV were appreciated. Postoperative complication and revision rates were similar. Conclusion Corticosteroid injections as a conservative treatment prior to rotator cuff repair do not significantly compromise postoperative function and are not associated with adverse postoperative complications or revision surgery compared to control patients. Level of Evidence: III; Retrospective Cohort Study