These authors investigated the temporal relationship between corticosteroid injections and the risk of surgical site infection after arthroscopic rotator cuff repair.
Using the PearlDiver database they identified 12,060 patients undergoing arthroscopic rotator cuff repair within 1 year of injection 48,763 undergoing arthroscopic rotator cuff repair without prior injection. Patients with preoperative injections were further stratified by the duration in months that the injection was performed prior to the surgical procedure. Surgical site infection within 6 months of the surgical procedure was recorded.
They no significant difference in the overall incidence of surgical site infection in patients receiving a shoulder injection. However, patients receiving an injection within 1 month prior to operative management had a significantly higher rate of surgical site infection overall at 1.3% compared with the control group at 0.8%. On multivariate analysis, male sex, obesity, diabetes, smoking, and preoperative corticosteroid injections within 1 month of the surgical procedure were independent risk factors for development of a surgical site infection.
Comment: This study provides a useful guideline for the timing of cuff surgery after a prior injection.
It would have been of interest to know the types of bacteria causing the infections noted in this study - were they Cutibacterium or the more aggressive types of Staph, Strep or gram negative bacteria? This gets to the question of how injection within one month increases the risk of infection. If the infections were by Cutibactium (commonly residing in the sebaceous glands of normal skin), one might wonder whether the bacteria were carried from the skin into the shoulder by the needle. If the infections were by bacteria not usually found in the skin, one might wonder if the corticosteroid rendered the joint more susceptible to transient bacteremia.
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Use the "Search" box to the right to find other topics of interest to you.
How you can support progress in shoulder surgery
You may be interested in some of our most visited web pages arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
