JSES - 2026-06-08 - Journal Article
Shoulder Muscle Adiposity Can Predict the Efficacy of Corticosteroid Injections in Treating Adhesive Capsulitis After Rotator Cuff Repair Surgery.
Chen NH, Lin CL, Cheng YH, Chiu YS, Hsu TH, Huang SW
Topics
Key Takeaway
Preoperative rotator cuff GFDI ≥1.875 predicts a six-fold increased odds of corticosteroid injection failure for post-RCR adhesive capsulitis (OR 6.020, P=0.049).
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Summary
This retrospective cohort examined whether preoperative Goutallier fatty degeneration index (GFDI) predicts corticosteroid injection efficacy in patients who developed adhesive capsulitis after primary rotator cuff repair. Patients were stratified into effective vs. ineffective groups based on pain and ROM at 8 weeks, with preoperative MRI GFDI as the primary predictor variable. Mean GFDI was significantly higher in the noneffective group (2.1±0.7 vs. 1.5±0.3; P<0.001), and GFDI ≥1.875 was the sole independent predictor of failure on logistic regression (OR 6.020).
Key Limitation
The total sample size is not reported in the abstract, making it impossible to evaluate whether the study was adequately powered to detect the logistic regression OR of 6.020 with only one significant predictor emerging from what is presumably a multivariable model.
Original Abstract
BACKGROUND
Shoulder stiffness is a common complication after rotator cuff repair (RCR) that may progress to adhesive capsulitis, impeding functional recovery. Although corticosteroid injections are frequently used, treatment response varies substantially across patients. This study investigated whether preoperative fatty infiltration into shoulder musculature predicts corticosteroid injection efficacy in managing post-RCR adhesive capsulitis.
METHODS
This retrospective cohort study included patients who developed adhesive capsulitis after primary RCR and subsequently received intra-articular corticosteroid injection between August 2013 and July 2022. Patients were stratified into effective and ineffective treatment groups by pain scores and range of motion at 8 weeks. Preoperative MRI assessed fatty infiltration using the Goutallier fatty degeneration index (GFDI). Receiver operating characteristic curve and binary logistic regression analyses identified key predictors.
RESULTS
The noneffective group exhibited significantly higher mean rotator cuff GFDI values than the effective group (2.1±0.7 vs. 1.5±0.3; P<0.001). GFDI ≥1.875 was the only significant independent predictor of treatment failure (OR: 6.020; P=0.049).
CONCLUSION
Preoperative fatty infiltration (GFDI ≥1.875) predicted six-fold increased risk of corticosteroid injection failure, helping clinicians identify high-risk patients for earlier alternative treatments.