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http://dx.doi.org/10.5397/cise.2015.18.2.80

Adrenal Insufficiency in Patients with Rotator Cuff Tear: Prevalence, Risk Factors and Influence on Outcome  

Kim, Jung-Han (Department of Orthopaedic Surgery, Busan Paik Hospital, Inje University College of Medicine)
Gwak, Heui-Chul (Department of Orthopaedic Surgery, Busan Paik Hospital, Inje University College of Medicine)
Publication Information
Clinics in Shoulder and Elbow / v.18, no.2, 2015 , pp. 80-85 More about this Journal
Abstract
Background: This study measured the rate of adrenal insufficiency among rotator cuff tear patients, and determined the roles of steroid treatment and herbal medicine as specific risk factors of adrenal insufficiency. Methods: We prospectively evaluated the 53 patients who agreed to participate in the study and underwent arthroscopic rotator cuff repair due to a chronic full-thickness tear from March 2012 to September 2013. The diagnosis of adrenal insufficieny was made by rapid adrenocortical hormone test before the operation. We collected information regarding their history of steroid and herbal medicine treatment within the last 12 months. Results: The rate of adrenal insufficiency among the rotator cuff tear patients in our study was 18.9% (10 of 53 patients). Steroid treatment (p=0.034), frequency of local steroid injection (p=0.008), and herbal medicine treatment (p=0.02) showed significant association with the risk of adrenal insufficiency. Conclusions: In this study, careful taking of a patient's medical history, such as the use of steroids and herbal medicine, is important when investigating adrenal function before surgery.
Keywords
Intra-articular steroid injection; Herbal medicine; Adrenal insufficiency; Rotator cuff tear;
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1 Matsen FA, Titelman RM, Lippitt SB, et al. Rotator cuff. In: Rockwood CA, Matsen FA, Matsen FA III, Wirth MA, Lippitt SB, Fehringer EV, eds. The shoulder. Philadelphia: WB Saunders;2004. 795-878.
2 Neer CS 2nd. Impingement lesions. Clin Orthop Relat Res. 1983;(173):70-7.
3 Bokor DJ, Hawkins RJ, Huckell GH, Angelo RL, Schickendantz MS. Results of nonoperative management of full-thickness tears of the rotator cuff. Clin Orthop Relat Res. 1993;(294):103-10.
4 Wong MW, Tang YN, Fu SC, Lee KM, Chan KM. Triamcinolone suppresses human tenocyte cellular activity and collagen synthesis. Clin Orthop Relat Res. 2004;(421):277-81.
5 Hugate R, Pennypacker J, Saunders M, Juliano P. The effects of intratendinous and retrocalcaneal intrabursal injections of corticosteroid on the biomechanical properties of rabbit Achilles tendons. J Bone Joint Surg Am. 2004;86(4):794-801.   DOI
6 Sacre K, Dehoux M, Chauveheid MP, et al. Pituitary-adrenal function after prolonged glucocorticoid therapy for systemic inflammatory disorders: an observational study. J Clin Endocrinol Metab. 2013;98(8):3199-205.   DOI   ScienceOn
7 Habib G, Artul S, Chernin M, Hakim G, Jabbour A. The effect of intra-articular injection of betamethasone acetate/betamethasone sodium phosphate at the knee joint on the hypothalamic-pituitary-adrenal axis: a case-controlled study. J Investig Med. 2013;61(7):1104-7.   DOI
8 Mader R, Lavi I, Luboshitzky R. Evaluation of the pituitaryadrenal axis function following single intraarticular injection of methylprednisolone. Arthritis Rheum. 2005;52(3):924-8.   DOI   ScienceOn
9 Arlt W, Allolio B. Adrenal insufficiency. Lancet. 2003;361(9372):1881-93.   DOI   ScienceOn
10 Oelkers W. Adrenal insufficiency. N Engl J Med. 1996;335(16):1206-12.   DOI   ScienceOn
11 Bornstein SR. Predisposing factors for adrenal insufficiency. N Engl J Med. 2009;360(22):2328-39.   DOI   ScienceOn
12 Habib GS. Systemic effects of intra-articular corticosteroids. Clin Rheumatol. 2009;28(7):749-56.   DOI
13 Lazarevic MB, Skosey JL, Djordjevic-Denic G, Swedler WI, Zgradic I, Myones BL. Reduction of cortisol levels after single intra-articular and intramuscular steroid injection. Am J Med. 1995;99(4):370-3.   DOI   ScienceOn
14 Duclos M, Guinot M, Colsy M, et al. High risk of adrenal insufficiency after a single articular steroid injection in athletes. Med Sci Sports Exerc. 2007;39(7):1036-43.   DOI   ScienceOn
15 Rispler DT, Sara J. The impact of complementary and alternative treatment modalities on the care of orthopaedic patients. J Am Acad Orthop Surg. 2011;19(10):634-43.   DOI
16 Armanini D, Fiore C, Mattarello MJ, Bielenberg J, Palermo M. History of the endocrine effects of licorice. Exp Clin Endocrinol Diabetes. 2002;110:257-61.   DOI   ScienceOn
17 van Staa TP, Leufkens HG, Abenhaim L, Begaud B, Zhang B, Cooper C. Use of oral corticosteroids in the United Kingdom. QJM. 2000;93(2):105-11.   DOI   ScienceOn
18 Matsuda S, Oda K, Kawaguchi M, Hayashi H. Histochemical studies on the effect of glycyrrhizin on corticoid metabolism. Nisshin Igaku Jpn J Med Prog. 1962;49:465-81.