Editorial Commentary: Corticosteroid Injections Administered Within 4 Weeks Before Shoulder Arthroscopy Are Associated With an Increased Risk of Infection

Corticosteroid injections are a frequently used modality for addressing shoulder pain. The widespread utilization of corticosteroid injections is supported by clinical practice guidelines and consensus statements including the 2019 American Academy for Orthopaedic Surgeons (AAOS) guidelines for the management of rotator cuff injuries. However, steroids may be detrimental to healing potential following cuff repair and increase the risk of re-tear. In addition, corticosteroid injections administered within 4 weeks prior to shoulder arthroscopy are associated with an increased risk of infection. The degree of risk is dependent on the timing of surgery with longer time intervals between injection and shoulder arthroscopy being associated with less risk. The next version of the AAOS clinical practice guidelines for managing rotator cuff tears should incorporate commentary on the specific risk of surgical site infection following pre-operative corticosteroid injections, as well as on the timing of injections, with the aim of increasing awareness of these potentially devastating adverse effects.