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

Oleg Dolkart, Ofir Chechik, Assaf Bivas, Tamar Brosh, Michael Drexler, Zachary Weinerman, Eran Maman

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Background Arthroscopic rotator cuff (RC) repair incorporates suture anchors to secure torn RC tendons to the greater tuberosity (GT) bone. RC repair strength depends on the anchor-bone interface and on the quality of the GT. We evaluated the effect of single and multiple corticosteroid injections on the pullout strength of suture anchors. Methods Fifty rats were divided into those receiving saline solution injection (control group), a single methylprednisolone acetate (MTA) injection (MTA1 group), or 3 once-weekly MTA injections (MTA3 group). Rats were killed humanely at 1 or 4 weeks after the last injection. A mini–suture anchor was inserted into the humeral head through the GT. Specimens were tested biomechanically. Results At 1 week after the last injection, the mean maximal pullout strength was significantly reduced in the MTA1 group (63.5%) and MTA3 group (56%) compared with the control group (P <.05 for both). Mean stiffness decreased significantly in both treatment groups compared with controls (P <.05). At 4 weeks after the last injection, there was a significant increase in the mean maximal pullout strength after single and triple MTA injections compared with values recorded at the 1-week time point (P <.05). At 4 weeks, the mean maximal pullout strength after a single MTA injection was 92.8% of the pullout strength measured in the control group. Conclusions We showed a significant detrimental effect of corticosteroid exposure on the pullout strength of a suture anchor at 1 week. However, this effect was transient and resolved within a relatively short period. These findings indicate that a waiting period is required between subacromial corticosteroid injection and RC repair surgery that involves the use of suture anchors.

Original languageEnglish
Pages (from-to)1789-1793
Number of pages5
JournalJournal of Shoulder and Elbow Surgery
Volume26
Issue number10
DOIs
StatePublished - 1 Oct 2017
Externally publishedYes

Keywords

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

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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