title: Predictors of success of corticosteroid injection for the management of rotator cuff disease.
abstract: BACKGROUND
  The use of subacromial corticosteroid injection (CSI) to treat rotator cuff tendinopathy is controversial. We hypothesized that characteristics such as activity level, American Shoulder and Elbow Surgeons (ASES) score, duration of symptoms, and status of the rotator cuff may be prognostic factors for resolution of symptoms postinjection.
  
  
  METHODS
  During a 12-month period, consecutive patients with rotator cuff disease were analyzed. Patients received subacromial CSI, oral NSAIDs, and physical therapy. Baseline ASES score, simple shoulder test, an activity scale, and demographic data were recorded. Patients who remained symptomatic and were indicated for surgery were considered failures. Patients that did not undergo surgery were reassessed after a minimum of 1 year.
  
  
  RESULTS
  Forty-nine patients met our criteria. Follow-up was obtained for 81.6%. Sixteen cases (40%) failed conservative treatment at final follow-up (22.4 ± 11 months). CSI were successful in 76.2% of males and 45% of females (p = 0.04). Full-thickness tears were present in 8% of the patients with symptom resolution and 25% of those that failed conservative treatment (p = 0.29). No significant difference was found in age, hand dominance, duration of symptoms, or any of the scoring systems.
  
  
  CONCLUSIONS
  It is difficult to predict outcomes after CSI. Our treatment strategy showed a 40% failure rate.
authors.affiliation: Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA ; Apartado 99-1000 San José, San José, Costa Rica.
authors.forename: Fernando
authors.initials: F
authors.lastname: Contreras
authors.affiliation: Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
authors.forename: Haydée C
authors.initials: HC
authors.lastname: Brown
authors.affiliation: Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Marx
keywords: conservative treatment; corticosteroid injection; nonoperative treatment; rotator cuff disease; rotator cuff tendinopathy; shoulder pain; subacromial corticosteroid injection; subacromial impingement; subacromial injection