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Subacromial corticosteroid injections transiently decrease suture anchor pullout strength: biomechanical studies in

Oleg Dolkart¹, Ofir Chechik¹, Assaf Bivas¹

¹Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Journal of Shoulder and Elbow Surgery

|July 11, 2017

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This summary is machine-generated.

Corticosteroid injections temporarily weaken suture anchor strength in rotator cuff repairs. Recovery occurs within four weeks, suggesting a necessary waiting period before surgery.

Area of Science:

Orthopedic Surgery
Biomedical Engineering
Pharmacology

Background:

Arthroscopic rotator cuff (RC) repair utilizes suture anchors for tendon reattachment to bone.
The integrity of the anchor-bone interface is crucial for successful RC repair.
The impact of corticosteroid injections on this interface remains a significant clinical question.

Purpose of the Study:

To investigate the biomechanical effects of single and multiple corticosteroid injections on suture anchor pullout strength.
To determine the time course of these effects on the anchor-bone interface.

Main Methods:

Fifty rats were allocated to control (saline), single methylprednisolone acetate (MTA), or triple MTA injection groups.
Suture anchors were inserted into the humeral head's greater tuberosity (GT).

Keywords:

Suture anchors biomechanics corticosteroids detrimental effects greater tuberosity rats rotator cuff repair subacromial injection

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Biomechanical testing assessed anchor pullout strength and stiffness at 1 and 4 weeks post-injection.

Main Results:

One week post-injection, both single and triple MTA groups showed significantly reduced mean maximal pullout strength and stiffness compared to controls.
By four weeks, pullout strength significantly increased in both MTA groups compared to the 1-week time point.
At four weeks, single MTA injection resulted in 92.8% of control pullout strength.

Conclusions:

Corticosteroid exposure significantly impairs suture anchor pullout strength at one week.
This detrimental effect is transient, with strength largely recovering by four weeks.
A waiting period between corticosteroid injection and rotator cuff repair surgery is indicated.