{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,2,11]],"date-time":"2023-02-11T05:12:24Z","timestamp":1676092344522},"reference-count":11,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Orthop Unfall"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background The present study used a systematic review to analyse the risk of perioperative injections during arthroscopic reconstruction of the rotator cuff of the shoulder. The questions of interest were whether perioperative local injection increases the infection risk and whether the number of postoperative revisions is increased.<\/jats:p><jats:p>\n          Material and Methods A systematic review of the U.\u200aS. National Library of Medicine\/National Institutes of Health (PubMed) database and the Cochrane Library was performed using the PRISMA checklist. The keywords used were \u201cshoulder\u201d and \u201carthroscopy\u201d and \u201cinjection\u201d and \u201crisk\u201d. In the course of the study, work that was not also primarily concerned with the reconstruction of the rotator cuff was excluded. English original articles and case series were included that contained at least some arthroscopic reconstructions of the rotator cuff. The risk of bias was determined using the Newcastle-Ottawa Scale. The content of the articles relevant to the research questions was analysed.<\/jats:p><jats:p>\n          Results 48 hits were primarily generated. 9 articles corresponded to the inclusion criteria and were analysed. In the 6 studies with details on the injected substances, cortisone was used in 98\u200a\u2013\u200a100% of the cases. The reported infection and revision rates based on insurance data were higher with injection than without. The risk of bias in the studies analysed here was rather low based on the Newcastle-Ottawa Score. The risk of infection after a cortisone injection before, during or after surgery was increased. Injection was associated with infection in up to 8% of cases with injections within two weeks of surgery. The risk of infection was increased by up to 11 times with injections within 4 weeks after the operation. Likewise, the risk of revision surgery after injection was increased, with the time intervals between injection and surgery sometimes differing between studies.<\/jats:p><jats:p>\n          Discussion Local infections and to a lesser extent revision surgery are associated with perioperative injections (with cortisone) within 3 months preoperatively and 4 weeks postoperatively. However, there were only database studies of insurance data with several studies from a few centres. Thus, no causal relationships could be proven. Currently, however, the following can be recommended using a cautious approach: The interval between injection with cortisone before surgery should be at least 2 weeks, better 3 months. No cortisone injections should be applied intraoperatively. Postoperatively, cortisone should not be injected for at least 4 weeks. If, in exceptional cases, deviations from these time limits are required, patients should be informed about an increased risk of complications.<\/jats:p>","DOI":"10.1055\/a-1394-6469","type":"journal-article","created":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T00:38:42Z","timestamp":1617064722000},"page":"517-525","source":"Crossref","is-referenced-by-count":0,"title":["Risk Analysis of Perioperative Injections in Arthroscopic Reconstruction of the Rotator Cuff of the Shoulder \u2013 A Systematic Review"],"prefix":"10.1055","volume":"160","author":[{"given":"Marius","family":"von Knoch","sequence":"additional","affiliation":[{"name":"Shoulder Surgery, Osterholz County Hospital, Osterholz-Scharmbeck, Germany"},{"name":"Shoulder Surgery, AMEOS Klinikum Seepark Geestland, Geestland, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mike H.","family":"Baums","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Trauma Surgery and Sports Traumatology, Catholic Hospital Ruhrgebiet Nord GmbH, Dorsten, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Lehmann","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Orthopaedics and Plastic Surgery, Georg-August-University G\u00f6ttingen Medical Centre, G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Frosch","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Orthopaedics and Plastic Surgery, Georg-August-University G\u00f6ttingen Medical Centre, G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,3,29]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.arthro.2018.08.042","article-title":"Preoperative injections may be an iatrogenic cause of reoperation after arthroscopic rotator cuff repair","volume":"35","author":"A Agarwalla","year":"2019","journal-title":"Arthroscopy"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1177\/0363546518825348","article-title":"The timing of corticosteroid injections after arthroscopic shoulder procedures affects postoperative infection risk","volume":"47","author":"M E Kew","year":"2019","journal-title":"Am J Sports Med"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/j.jse.2015.08.039","article-title":"The timing of elective shoulder surgery after shoulder injection affects postoperative infection risk in Medicare patients","volume":"25","author":"B C Werner","year":"2016","journal-title":"J Shoulder Elbow Surg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1177\/0363546517749212","article-title":"Risk factors for infection after shoulder arthroscopy in a large medicare population","volume":"46","author":"J M Cancienne","year":"2018","journal-title":"Am J Sports Med"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/j.arthro.2018.10.116","article-title":"Injections prior to rotator cuff repair are associated with increased rotator cuff revision rates","volume":"35","author":"A E Weber","year":"2019","journal-title":"Arthroscopy"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"e1000100","DOI":"10.1371\/journal.pmed.1000100","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration","volume":"6","author":"A Liberati","year":"2009","journal-title":"PLoS Med"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1055\/a-0608-5226","article-title":"Arthroscopic Reconstruction of Intratendinous Lesions of the Supraspinatus Tendon \u2013 a Systematic Review","volume":"156","author":"M von Knoch","year":"2018","journal-title":"Z Orthop Unfall"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"2098","DOI":"10.1016\/j.jse.2019.03.037","article-title":"Preoperative corticosteroid joint injections within 2 weeks of shoulder arthroscopies increase postoperative infection risk","volume":"28","author":"S Bhattacharjee","year":"2019","journal-title":"J Shoulder Elbow Surg"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"682","DOI":"10.2106\/JBJS.18.00631","article-title":"The timing of injections prior to arthroscopic rotator cuff repair impacts the risk of surgical site infection","volume":"101","author":"B Forsythe","year":"2019","journal-title":"J Bone Joint Surg Am"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1016\/j.arthro.2018.10.107","article-title":"Preoperative shoulder injections are associated with increased risk of revision rotator cuff repair","volume":"35","author":"S A Traven","year":"2019","journal-title":"Arthroscopy"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.arthro.2018.07.043","article-title":"Increasing numbers of shoulder corticosteroid injections within a year preoperatively may be associated with a higher rate of subsequent revision rotator cuff surgery","volume":"35","author":"V S Desai","year":"2019","journal-title":"Arthroscopy"}],"container-title":["Zeitschrift f\u00fcr Orthop\u00e4die und Unfallchirurgie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1394-6469.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T10:34:26Z","timestamp":1676025266000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1394-6469"}},"subtitle":["Perioperative Injections"],"short-title":[],"issued":{"date-parts":[[2021,3,29]]},"references-count":11,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2022,9,27]]},"published-print":{"date-parts":[[2022,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1394-6469","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1864-6697","1864-6743"],"issn-type":[{"value":"1864-6697","type":"print"},{"value":"1864-6743","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,29]]}}}