Rajani Amyn M, Shah Urvil A, Mittal Anmol Rs, Gupta Sheetal, Garg Rajesh, Rajani Alisha A, Shetty Gautam, Punamiya Meenakshi, Singhal Richa
Department of Orthopaedics, Breach Candy Hospital, Mumbai, India.
Department of Orthopaedics, Surgikids Hospital, Ahmedabad, India.
Clin Shoulder Elb. 2023 Mar;26(1):64-70. doi: 10.5397/cise.2022.01256. Epub 2023 Feb 23.
This study aimed to analyze the efficacy of single-dose corticosteroid injection (CSI) administered at 6 weeks postoperative to treat stiffness following arthroscopic rotator cuff repair (ARCR).
In this prospective, multicentric, case-control study, post-ARCR stiffness at 6 weeks was treated with either a single dose of intra-articular CSI (CSI group) or physical therapy with oral analgesics (non-CSI group). Pain intensity according to visual analog scale (VAS), functional outcome using the Constant Murley Shoulder Score, time to return to activities of daily living (ADLs), and retear rate were recorded at 6 weeks, 9 weeks, 12 weeks, 6 months, 12 months, and 18 months postoperatively in both groups.
A total of 149 patients (54.5%) in the CSI group and 124 patients (45.5%) in the non-CSI group were included in this study. Pain and function were significantly better in the CSI group at 9-week, 12-week, and 6-month (P<0.001) follow-up, whereas they were not significantly different when the groups were compared at 12- and 18-month follow-up. The mean duration to return to ADLs was significantly shorter (P<0.001) in the CSI group. The incidence of retears was not significantly different (P=0.36) between groups at the end of 18 months of follow-up.
Single-dose intra-articular CSI administered at 6 weeks postoperative to treat post-ARCR stiffness significantly improved pain, function, and duration of return to ADLs without increasing the risk of retears compared to patients who did not receive intra-articular CSI.
本研究旨在分析在关节镜下肩袖修复术(ARCR)术后6周给予单剂量皮质类固醇注射(CSI)治疗僵硬的疗效。
在这项前瞻性、多中心、病例对照研究中,对ARCR术后6周的僵硬情况,一组采用单剂量关节内CSI治疗(CSI组),另一组采用物理治疗加口服镇痛药(非CSI组)。两组均在术后6周、9周、12周、6个月、12个月和18个月记录根据视觉模拟量表(VAS)评估的疼痛强度、使用Constant Murley肩关节评分评估的功能结果、恢复日常生活活动(ADL)的时间以及再撕裂率。
本研究纳入了CSI组的149例患者(54.5%)和非CSI组的124例患者(45.5%)。在9周、12周和6个月的随访中,CSI组的疼痛和功能明显更好(P<0.001),而在12个月和18个月的随访中,两组比较差异无统计学意义。CSI组恢复ADL的平均时间明显更短(P<0.001)。在18个月随访结束时,两组之间的再撕裂发生率差异无统计学意义(P=0.36)。
与未接受关节内CSI的患者相比,ARCR术后6周给予单剂量关节内CSI治疗僵硬可显著改善疼痛、功能和恢复ADL的时间,且不增加再撕裂风险。