Does microvascularization of the footprint play a role in rotator cuff healing of the shoulder?

Bonnevialle, Nicolas; Bayle, Xavier; Faruch, Marie; Wargny, Matthieu; Gomez‐Brouchet, Anne; Mansat, Pierre

doi:10.1016/j.jse.2015.04.012

Cited by 30 publications

(19 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additional prognosis factors have been found by other authors like preoperative acromio-humeral distance [26,28], smoking status [29,30], use of anti-inflammatory drugs [31], use of steroid injections [32,33], and quality of vascularization of the footprint [34,35]. However, we could not demonstrate any statistical influence of these parameters in our study.…”

Section: Discussioncontrasting

confidence: 51%

Clinical and anatomic results of surgical repair of chronic rotator cuff tears at ten-year minimum follow-up

Elia

Azoulay

Lebon

et al. 2017

International Orthopaedics (SICOT)

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussioncontrasting

confidence: 51%

Clinical and anatomic results of surgical repair of chronic rotator cuff tears at ten-year minimum follow-up

Elia

Azoulay

Lebon

et al. 2017

International Orthopaedics (SICOT)

Self Cite

View full text Add to dashboard Cite

show abstract

“…In this study, the absence of adverse events could be attributed to the reliable injection technique performed by the same experienced radiologist. Therefore, perhaps some reasons for the poorer outcomes with postoperative CSIs are detailed in previous studies indicating that CSIs can cause adverse effects, such as specific cell toxicity,13, 39 alteration of the collagen composition and extracellular matrix, 25 and decreasing microvascularization of the rotator cuff footprint 8 . Conversely, Bhatia et al 6 studied the natural progression of rotator cuff tear in patients who underwent CSI for conservative treatment of impingement syndrome and found no difference in tear progression between patients who received fewer or more than 3 injections, suggesting that CSIs may not be a causative factor of rotator cuff tear.…”

Section: Discussionmentioning

confidence: 99%

“…The benefits of CSIs must be balanced against their potential harms, reported in laboratory and animal studies 5, 28, 31, 45, 50, 52. Whereas biopsy studies revealed that CSIs could reduce microvascularization at the rotator cuff footprint 8 and decrease cell proliferation, 13 other studies reported no deleterious effects 6, 17, 33. The controversy led to more cautious use of CSIs in the clinical setting, for example, to improve needle positioning using radiology-assisted techniques 15, 24, 32, 37, 41.…”

mentioning

confidence: 99%

Do corticosteroid injections compromise rotator cuff tendon healing after arthroscopic repair?

et al. 2018

View full text Add to dashboard Cite

BackgroundRotator cuff tears are associated with capsular contraction and stiffness that should be restored before surgical repair. Corticosteroid injections (CSIs) are frequently used as conservative treatments before surgical repair. This study aimed to determine the influence of preoperative and postoperative CSIs on clinical and anatomic outcomes after rotator cuff repair.MethodsThe authors analyzed the records of 257 patients who had arthroscopic rotator cuff repair, of whom 212 were evaluated at 3.1 ± 1.0 years (median, 2.9 years; range, 1.4-7.1 years) by clinical (Constant score) and ultrasound (Sugaya classification) examinations. Univariable and multivariable regressions were performed to determine associations between outcomes and administration of preoperative and postoperative CSIs, patient characteristics, and tendon characteristics.ResultsThe Constant scores improved from 56.4 ± 15.1 to 80.8 ± 12.5. Multivariable regression confirmed that postoperative scores were associated with postoperative CSIs (P < .001), preoperative scores (P < .001), gender (P < .001), and fatty infiltration (P < .005). Retears (Sugaya types IV-V) were observed in 27 shoulders (13%). Multivariable regression clarified that retear rates were associated only with postoperative CSIs (P = .007) and stage 3 fatty infiltration (P = .001). Adjusting for confounders, an additional postoperative CSI would decrease scores by 4.7 points and double retear risks.DiscussionPreoperative CSIs had no influence on clinical scores and retear rates, whereas postoperative CSIs were associated with lower scores and more retears. Although we can infer that preoperative CSIs do not affect outcomes, we cannot determine whether postoperative CSIs compromised outcomes or were administered in patients who had already poor outcomes. Our findings may resolve controversies about the administration of preoperative CSIs.

show abstract

“…In addition, human tissue cytology studies have shown that corticosteroid treatment is associated with higher cell apoptosis at the surgical site [27]. Although some basic studies have shown that corticosteroids may have a negative effect on postoperative tissue healing, some clinical studies have shown that early intraarticular injection of corticosteroids after arthroscopic rotator cuff repair does not increase the tear rate [21,28]. Our research demonstrated that there was no signi cant difference in tear rate, constant score, ASES score and UCLA score.…”

Section: Discussionmentioning

confidence: 53%

Safety and Effectiveness of Intra-articular Corticosteroid Injection Following Arthroscopic Shoulder Surgery

Wang²,

Tang³

2020

Preprint

View full text Add to dashboard Cite

Background To evaluate the safety and effectiveness of intra-articular corticosteroid injection following arthroscopic shoulder surgery. Method PubMed, Cochrane Library, EMBASE, Web of Science and CNKI were retrieved from the inception of electronic databases to June 2020. All analyses were performed using Stata/SE 15.1 version (StataCorp). Result 6 papers were included in this meta-analysis. There was no significant difference in tear rate (OR = 0.713, 95% CI: 0.450 to 1.129, P = 0.149), constant score (MD = 6.212, 95% CI: 2.552 to 9.971, P = 0.001), rating scale of the American shoulder and elbow surgeons (ASES) score (MD=-0.116, 95% CI: -1.769 to 1.546) and the university of California at Los Angeles shoulder rating (UCLA) score (MD = -1.461, 95% CI: -3.221 to 0.299). The infection rate of patients who received corticosteroid injection within 1 month after operation was significantly higher (P < 0.05), but there was no significant change in the infection rate of patients who received corticosteroid injection within 2–4 months after operation. Conclusion The use of corticosteroids after shoulder arthroscopy will not increase the rate of postoperative tears, but the injection of corticosteroid within 1 month will increase the postoperative infection rate.

show abstract

Does microvascularization of the footprint play a role in rotator cuff healing of the shoulder?

Cited by 30 publications

References 37 publications

Clinical and anatomic results of surgical repair of chronic rotator cuff tears at ten-year minimum follow-up

Clinical and anatomic results of surgical repair of chronic rotator cuff tears at ten-year minimum follow-up

Do corticosteroid injections compromise rotator cuff tendon healing after arthroscopic repair?

Safety and Effectiveness of Intra-articular Corticosteroid Injection Following Arthroscopic Shoulder Surgery

Contact Info

Product

Resources

About