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Timing of Shoulder Injections Impacts Surgical Infection Risk

Apr 18, 2019 3:50 pm

A study of patients undergoing arthroscopic rotator cuff repair shows that corticosteroid injections in the month prior to surgery are associated with a significantly increased risk of surgical site infection.

A large claims database review examined patients undergoing arthroscopic rotator cuff repair and compared those undergoing arthroscopic rotator cuff repair within 1 year of injection (n=12,060), and those undergoing arthroscopic rotator cuff repair without prior injection (n = 48,763).  The primary outcome was surgical site infection within 6 months of the procedure. 

While there was no overall difference in the incidence of surgical site infection in patients receiving a shoulder injection (0.7%) and those without injection (0.8%), the investigators did find a significantly higher rate of infection in patients receiving an injection within 1 month prior (1.3% vs 0.8%; R, 1.7 [95% CI, 1.0 to 2.9]; p = 0.04).

Risk factors for infections included being male (OR, 1.7), obesity (OR 1.4), diabetes (OR 1.3), smoking (OR 1.7) and and preoperative corticosteroid injections within 1 month of the surgical procedure (OR, 2.1). 

Corticosteroid injections should be avoided if surgical arthroscopic rotator cuff repair is soon contemplated. 

Disclosures
The author has no conflicts of interest to disclose related to this subject

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