Postoperative Corticosteroid Injection After Arthroscopic Rotator Cuff Repair in Patients With Stiffness Has Similar Clinical Outcome Compared With Repair Combined With Capsular Release: A Prospective Randomized Clinical Trial

医学 肩袖 外科 随机对照试验 运动范围 皮质类固醇 曲安奈德 袖口 前瞻性队列研究
作者
Hyo Jin Lee,Eun-Ji Yoon,Jung Woo Lee,Jongik Kim,Jong-Ho Kim
出处
期刊:Arthroscopy [Elsevier BV]
卷期号:41 (8): 2809-2818 被引量:2
标识
DOI:10.1016/j.arthro.2025.02.014
摘要

PURPOSE: To investigate whether 2 months of a postoperative intra-articular corticosteroid injection after arthroscopic rotator cuff repair (ARCR) in rotator cuff tear (RCT) patients with stiffness would improve the functional scores and range of motion of the operated shoulder without capsular release during ARCR. METHODS: From March 2020 to September 2021, a total of 73 patients who had RCT with stiffness and were scheduled for ARCR were enrolled prospectively and randomly allocated into 2 groups. The patients who underwent ARCR with capsular release were allocated to group 1 (n = 37). The patients who underwent ARCR without capsular release and were injected with 1 mL triamcinolone acetate (40 mg/1 cc) into the glenohumeral joint 2 months after surgery were allocated to group 2 (n = 36). Functional scores and shoulder range of motion were evaluated before surgery; 3, 6, and 12 months after surgery; and at the last follow-up. Magnetic resonance imaging was performed at 12 months postoperatively. RESULTS: The mean follow-up period was 26.5 months. The functional and visual analog score (VAS) pain scores in both groups were significantly improved at the last follow-up (P < .001). The 3-month postoperative VAS pain score of group 2 was significantly lower than that of group 1 (group 1, 3.4 ± 1.5; group 2, 2.1 ± 1.0; P <.001). VAS pain scores at 6 months or 12 months or at the last follow-up and functional scores and ROM at 3, 6, or 12 months or at the last follow-up were not significantly different between the 2 groups (P > .05). The retear rate of repaired rotator cuff during follow-up was not significantly different between the 2 groups (P = .71). CONCLUSIONS: Corticosteroid injection in the glenohumeral joint performed 2 months after ARCR in RCT patients with stiffness is as effective as capsular release during ARCR for improving the clinical outcome of the operated shoulder. LEVEL OF EVIDENCE: Level I, prospective randomized clinical trial.
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