The effect of pre-operative shoulder injections on post-operative opioid use, infection and revision following shoulder arthroplasty.
cortisone
injection
revision arthroplasty
shoulder arthroplasty
Journal
Shoulder & elbow
ISSN: 1758-5732
Titre abrégé: Shoulder Elbow
Pays: United States
ID NLM: 101506589
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
03
10
2021
revised:
09
06
2022
accepted:
14
06
2022
pmc-release:
01
09
2024
medline:
11
9
2023
pubmed:
11
9
2023
entrez:
11
9
2023
Statut:
ppublish
Résumé
Treatment of glenohumeral osteoarthritis (GHOA) may include conservative management with use of intraarticular injections, prior to considering total shoulder arthroplasty (TSA). The purpose of this study was to assess trends in the use of preoperative cortisone (CO) and hyaluronic acid (HA) injections, as well as investigate the relationship between injection use and infection or revision arthroplasty following TSA. Pearl Driver was used to identify all patients undergoing TSA for GHOA between 2010 and 2018. Patients were categorized based on the type and number of injections they received. Outcomes of interest included post-operative opioid use, post-operative infection, and risk of revision surgery within 1 year of the index procedure. The incidence of patients receiving a CO or HA injections within 1 year of their TSA decreased by 83% and 54%, respectively. Patients who had received 1 or more steroid injections had higher odds of prolonged opiate use following surgery. Patients that received 1 or 2 CO injection prior to TSA had an increased risk of needing revision surgery. Use of intraarticular injections for the management of GHOA has declined. Patients receiving preoperative injections had increased odds of prolonged opiate use and the need for revision surgery.
Sections du résumé
Background
UNASSIGNED
Treatment of glenohumeral osteoarthritis (GHOA) may include conservative management with use of intraarticular injections, prior to considering total shoulder arthroplasty (TSA). The purpose of this study was to assess trends in the use of preoperative cortisone (CO) and hyaluronic acid (HA) injections, as well as investigate the relationship between injection use and infection or revision arthroplasty following TSA.
Methods
UNASSIGNED
Pearl Driver was used to identify all patients undergoing TSA for GHOA between 2010 and 2018. Patients were categorized based on the type and number of injections they received. Outcomes of interest included post-operative opioid use, post-operative infection, and risk of revision surgery within 1 year of the index procedure.
Results
UNASSIGNED
The incidence of patients receiving a CO or HA injections within 1 year of their TSA decreased by 83% and 54%, respectively. Patients who had received 1 or more steroid injections had higher odds of prolonged opiate use following surgery. Patients that received 1 or 2 CO injection prior to TSA had an increased risk of needing revision surgery.
Discussion
UNASSIGNED
Use of intraarticular injections for the management of GHOA has declined. Patients receiving preoperative injections had increased odds of prolonged opiate use and the need for revision surgery.
Identifiants
pubmed: 37692872
doi: 10.1177/17585732221114647
pii: 10.1177_17585732221114647
pmc: PMC10492524
doi:
Types de publication
Journal Article
Langues
eng
Pagination
87-94Informations de copyright
© The Author(s) 2022.
Déclaration de conflit d'intérêts
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Références
J Shoulder Elbow Surg. 2016 Mar;25(3):390-7
pubmed: 26651428
J Shoulder Elbow Surg. 2015 Dec;24(12):e323-30
pubmed: 26163282
J Shoulder Elbow Surg. 2015 May;24(5):741-6
pubmed: 25595360
J Shoulder Elbow Surg. 2020 Mar;29(3):541-549
pubmed: 31594726
Cochrane Database Syst Rev. 2003;(1):CD004016
pubmed: 12535501
Sports Health. 2013 Mar;5(2):153-9
pubmed: 24427384
Trials. 2013 Dec 10;14:425
pubmed: 24325987
J Shoulder Elbow Surg. 2012 Nov;21(11):1534-41
pubmed: 22516570
Clin Orthop Relat Res. 2014 Sep;472(9):2809-15
pubmed: 24906812
Am J Sports Med. 2018 Mar;46(4):809-814
pubmed: 29309200
J Arthroplasty. 2020 Aug;35(8):1979-1982
pubmed: 32376168
Mod Rheumatol. 2014 Jul;24(4):667-70
pubmed: 24289196
J Shoulder Elbow Surg. 2021 May;30(5):1128-1134
pubmed: 32858193
Shoulder Elbow. 2016 Jul;8(3):203-14
pubmed: 27583021
Shoulder Elbow. 2015 Jul;7(3):154-6
pubmed: 27582970
Am J Sports Med. 2016 Jan;44(1):177-82
pubmed: 26216105
Shoulder Elbow. 2020 Dec;12(1 Suppl):81-87
pubmed: 33343719
J Am Acad Orthop Surg. 2020 Oct 1;28(19):790-794
pubmed: 32804699