Tuesday, 28 Jan 2020

You are here

Timing of Shoulder Injections Impacts Surgical Infection Risk

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

Add new comment

More Like This

NSAIDs May Impair Healing if Taken Nightly

A new study in Scientific Reports suggest that circadian rhythms play an important role in wound healing, and that nonsteroidal anti-inflammatory drugs (NSAIDs) may be disruptive if taken at night given primary healing that occurs in a body at night. 

QD Clinic - "Doc, When Can I Stop?"

QD Clinic - Lessons from the clinic. In this video: Patients stable on a biologic need guidance on when, and if, they can stop their biologic.

QD Clinic - Dealing with Non-adherence

QD Clinic - Lessons from the clinic. Today’s clinic topic: Dealing with Non-Adherence in the Clinic.

NSAID Safety Guidelines

Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for acute or chronic arthritis, headache, visceral pain, postoperative pain, etc but come with a small but significant risk of serious adverse effects, including hypertension, cardiovascular disease, kidney injury and GI complications.

Poor Sleep Increases Risk of Cognitive Decline

The Journal of Neurology, Neurosurgery & Psychiatry reports there is moderate evidence that six sleep disorders (insomnia, fragmentation, daytime dysfunction, prolonged latency, rapid eye movement sleep behaviour disorder and excessive time in bed) significantly increases the risk of cognitive disorders.

Metanalysis of 51 previously published reports looked at sleep issues and cognitive health over time.