Association between corticosteroid therapy and diagnosis of non-traumatic rotator cuff tear or rupture in patients followed in orthopedic practices in Germany

摘要

Abstract. Aims: The purpose of this case-control study was to examine the association between oral and injected cortico-steroids (CS) and subsequent non-traumatic rotator cuff tear or rupture (nt RCT or RCR) in orthopedic practices in Germany. Materials and methods: Patients diagnosed with nt RCT or RCR between January 2017 and December 2019 (index date) were included in the study after applying inclusion and exclusion criteria. Controls without nt RCT or RCR were matched using propensity scores based on age, sex, observation time prior to the index date (years), and diseases of the musculoskeletal system and connective tissue. Results: A total of 10,986 patients were included in each group. For both oral and injected CS, we found a significant association with nt RCT or RCR, whereby oral CS had a stronger impact (OR (oral): 1.71 (95% CI: 1.52 -1.93) vs. OR (injected): 1.42 (95% CI: 1.28 - 1.58)). For oral CS, this association was largely unaffected by differences in total doses or latencies between therapy end and index date. Within the group who received injected CS, shorter latencies and total doses of 20 mg or more led to higher odds of nt RCT or RCR. Varying CS had a different impact on rotator cuff tendons. Non-steroidal anti-inflammatory drugs (NSAIDs) were not associated with nt RCT or RCR at all. Conclusion: Oral and injected CS were associated with nt RCT or RCR in patients treated in orthopedic practices in Germany, while analgesics such as NSAIDs were not.