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Predictors of Success of Corticosteroid Injection for the Management of Rotator Cuff Disease

  • Original Article
  • Published:
HSS Journal ®

Abstract

Background

The use of subacromial corticosteroid injection (CSI) to treat rotator cuff tendinopathy is controversial. We hypothesized that characteristics such as activity level, American Shoulder and Elbow Surgeons (ASES) score, duration of symptoms, and status of the rotator cuff may be prognostic factors for resolution of symptoms postinjection.

Methods

During a 12-month period, consecutive patients with rotator cuff disease were analyzed. Patients received subacromial CSI, oral NSAIDs, and physical therapy. Baseline ASES score, simple shoulder test, an activity scale, and demographic data were recorded. Patients who remained symptomatic and were indicated for surgery were considered failures. Patients that did not undergo surgery were reassessed after a minimum of 1 year.

Results

Forty-nine patients met our criteria. Follow-up was obtained for 81.6%. Sixteen cases (40%) failed conservative treatment at final follow-up (22.4 ± 11 months). CSI were successful in 76.2% of males and 45% of females (p = 0.04). Full-thickness tears were present in 8% of the patients with symptom resolution and 25% of those that failed conservative treatment (p = 0.29). No significant difference was found in age, hand dominance, duration of symptoms, or any of the scoring systems.

Conclusion

It is difficult to predict outcomes after CSI. Our treatment strategy showed a 40% failure rate.

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Acknowledgments

The authors thank Joseph Nguyen for his help with the preparation of the statistics for this manuscript.

Disclosures

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. One or more of the authors has or may receive funding from a biomedical entity that may be perceived as a potential conflict of interest.

Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Authors and Affiliations

  1. Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Fernando Contreras MD, Haydée C. Brown MD & Robert G. Marx MD, FCRSC

  2. Apartado 99-1000 San José, San José, Costa Rica

    Fernando Contreras MD

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  1. Fernando Contreras MD
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  2. Haydée C. Brown MD
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  3. Robert G. Marx MD, FCRSC
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Correspondence to Fernando Contreras MD.

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Level of Evidence: Level IV: Therapeutic study.

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Contreras, F., Brown, H.C. & Marx, R.G. Predictors of Success of Corticosteroid Injection for the Management of Rotator Cuff Disease. HSS Jrnl 9, 2–5 (2013). https://doi.org/10.1007/s11420-012-9316-6

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