Safety of intraarticular corticosteroid injections after arthroscopic shoulder surgery: a systematic review and meta-analysis

doi:10.3969/j.issn.2095-4344.2715

Abstract

Abstract:

BACKGROUND: Intraarticular injection of corticosteroids after arthroscopic shoulder surgery is one of the effective methods to relieve shoulder pain and stiffness after surgery. However, whether the use of corticosteroids will increase the complications associated with arthroscopic shoulder surgery is still controversial.

OBJECTIVE: To evaluate the safety and clinical efficacy of corticosteroid injections after arthroscopic shoulder surgery.

METHODS: The electronic databases including PubMed, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for clinical controlled trials of corticosteroid injection into the articular cavity after arthroscopic shoulder surgery from the inception of the databases to September 2019. Data extraction and quality appraisement were performed independently by two investigators according to inclusion and exclusion criteria. Merging and analysis of effect quantities was conducted on RevMan 5.3 software.

RESULTS AND CONCLUSION: (1) A total of six comparative studies were included. A total of 7 418 patients were enrolled, of which 3 920 were in the corticosteroid injections group and 3 498 in the control group. (2) Meta-analysis showed that there was no significant difference in tear rate, Constant score, ASES score and UCLA score between the two groups [OR=0.71, 95%CI[0.45, 1.13], P=0.15; MD=-0.99, 95% CI(-12.44, 10.46), P=0.87; MD=-0.12, 95%CI(−1.80, 1.56), P=0.89; MD=−1.46, 95%CI(−3.22, 0.30), P=0.10]. The infection rate of corticosteroid injections group was higher than that of control group (P < 0.05). There was no significant difference in infection rate between the two groups 2-4 months after arthroscopy (P > 0.05). (3) The results showed that the injection of corticosteroids did not increase the rate of postoperative tear, but the injection of corticosteroids within one month after the operation would increase the rate of postoperative infection. Therefore, when using corticosteroids after the operation, clinicians should weigh the advantages and disadvantages according to the actual situation of patients, and pay attention to avoid injecting intraarticular hormone treatment within 1 month after operation.

Key words: corticosteroid injections, corticosteroid, shoulder arthroscopy, intraarticular injection, clinical efficacy, safety, systematic review, meta-analysis

CLC Number:

Fan Zhirong, Su Haitao, Jiang Tao, Zhou Junde, Peng Jiajie, Hong Weiwu, Zhou Lin, Huang Huida. Safety of intraarticular corticosteroid injections after arthroscopic shoulder surgery: a systematic review and meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(24): 3931-3936.

Figures/Tables 7

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