The Efficacy of Subacromial Corticosteroid Injection in the ... : JAAOS - Journal of the American Academy of Orthopaedic Surgeons (original) (raw)

Guest Editorial

The Efficacy of Subacromial Corticosteroid Injection in the Treatment of Rotator Cuff Disease: A Systematic Review

Koester, Michael C. MD, ATC; Dunn, Warren R. MD, MPH; Kuhn, John E. MD; Spindler, Kurt P. MD

Dr. Koester is Physician, Orthopedic Healthcare Northwest, Eugene, OR. Dr. Dunn is Assistant Professor of Orthopaedics and Assistant Professor of Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN. Dr. Kuhn is Associate Professor and Chief of Shoulder Surgery, Vanderbilt Sports Medicine, Vanderbilt University Medical Center. Dr. Spindler is Professor and Vice Chairman, Vanderbilt Orthopaedic Institute, Vanderbilt University Medical Center.

None of the following authors has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Koester, Dr. Kuhn, and Dr. Spindler. Dr. Dunn has received research or institutional support from Pfizer.

Reprint requests: Dr. Spindler, Vanderbilt Orthopaedic Institute, Vanderbilt University Medical Center, Medical Center East, Suite 4200, South Tower, Nashville, TN 37232-8774.

Abstract

To investigate whether subacromial corticosteroid injections are effective in the treatment of rotator cuff disease, an evidence-based systematic review was undertaken of nine randomized controlled trials that compared subacromial corticosteroid injection with placebo in patients with rotator cuff disease. Each study was systematically evaluated for biases, and outcome measures were scrutinized for statistical significance and clinical importance. One study demonstrated clinically important differences in pain relief. Two studies showed clinically important improvement in range of motion at final follow-up. This systematic review of the available literature indicates that there is little reproducible evidence to support the efficacy of subacromial corticosteroid injection in managing rotator cuff disease.