A Positive Correlation between Steroid Injections and Cuff Tendon Tears: A Cohort Study Using a Clinical Database

Area of Science:

• Orthopedics
• Musculoskeletal Diseases
• Pharmacology

Background:

• Corticosteroid injections are common treatments for shoulder diseases.
• Potential adverse effects, such as tendon rupture, warrant investigation.
• Understanding risk factors for rotator cuff tears is crucial for patient management.

Purpose of the Study:

• To investigate the association between shoulder steroid injections and the incidence of cuff tendon tears.
• To quantify the risk of rotator cuff tears following corticosteroid injections.
• To identify other risk factors contributing to cuff tendon tears.

Main Methods:

• Retrospective cohort study utilizing the Kaohsiung Veterans General Hospital clinical database.
• Patients with shoulder disease were categorized into case (steroid injection) and control (no injection) groups.
• Cox regression analysis was employed to calculate adjusted hazard ratios for cuff tendon tears, controlling for sex, age, and comorbidities.

Main Results:

• The incidence of cuff tendon tears was 9.8% in the steroid injection group (p < 0.001).
• Steroid injections were associated with a 7.44-fold increased risk of cuff tendon tears (adjusted hazard ratio = 7.44, p < 0.001).
• Smoking (aHR = 2.40, p = 0.046) and chronic liver disease (aHR = 3.25, p = 0.007) were also significant risk factors.

Conclusions:

• Shoulder corticosteroid injections are significantly associated with an increased risk of cuff tendon tears.
• Concurrent chronic liver disease and smoking further elevate the risk of rotator cuff tears.
• Clinical practice should consider these risks when prescribing shoulder steroid injections.