Steroid or NSAID Treatment in Perioperative Period for Rotator Cuff Repair
We cannot recommend for or against the use of perioperative subacromial corticosteroid injections or non-steroidal anti-inflammatory medications in patients undergoing rotator cuff surgery.
Rationale
After a systematic search of the literature, we found no clinical data that supported or refuted a negative or positive effect of subacromial corticosteroid injections on tendon healing or outcomes after rotator cuff repair. Therefore, the work group could not recommend for or against their use in the perioperative period as the evidence was inconclusive.
Non-steroidal anti-inflammatory medications have the potential benefits of limiting pain and swelling associated with rotator cuff repair surgery. While the clinical effects of NSAIDs have been evaluated in the non-operative treatment of patients with rotator cuff symptoms in the absence of a full-thickness tear, we found no evidence supporting or refuting their usage in the postoperative period after rotator cuff repair. Specifically, the work group was concerned about the possible negative affects of NSAIDs on tendon healing. There is no clinical data supporting or refuting a negative or positive affect on rotator cuff tendon healing therefore the group found that the evidence with regard to NSAIDS on healing was inconclusive. If NSAIDs are utilized, appropriate prudence should be exercised as this treatment modality is associated with potential adverse side effects including gastrointestinal bleeding, renal injury and platelet dysfunction.
Non-steroidal anti-inflammatory medications have the potential benefits of limiting pain and swelling associated with rotator cuff repair surgery. While the clinical effects of NSAIDs have been evaluated in the non-operative treatment of patients with rotator cuff symptoms in the absence of a full-thickness tear, we found no evidence supporting or refuting their usage in the postoperative period after rotator cuff repair. Specifically, the work group was concerned about the possible negative affects of NSAIDs on tendon healing. There is no clinical data supporting or refuting a negative or positive affect on rotator cuff tendon healing therefore the group found that the evidence with regard to NSAIDS on healing was inconclusive. If NSAIDs are utilized, appropriate prudence should be exercised as this treatment modality is associated with potential adverse side effects including gastrointestinal bleeding, renal injury and platelet dysfunction.