Triamcinolone Acetonide Acetate

To investigate whether 2 months of a postoperative intra-articular corticosteroid injection after arthroscopic rotator cuff repair (ARCR) in rotator cuff tear (RCT) patients with stiffness would improve the functional scores and range of motion of the operated shoulder without capsular release during ARCR.

From March 2020 to September 2021, a total of 73 patients who had RCT with stiffness and were scheduled for ARCR were enrolled prospectively and randomly allocated into 2 groups. The patients who underwent ARCR with capsular release were allocated to group 1 (n = 37). The patients who underwent ARCR without capsular release and were injected with 1 mL triamcinolone acetate (40 mg/1 cc) into the glenohumeral joint 2 months after surgery were allocated to group 2 (n = 36). Functional scores and shoulder range of motion were evaluated before surgery; 3, 6, and 12 months after surgery; and at the last follow-up. Magnetic resonance imaging was performed at 12 months postoperatively.

The mean follow-up period was 26.5 months. The functional and visual analog score (VAS) pain scores in both groups were significantly improved at the last follow-up (P < .001). The 3-month postoperative VAS pain score of group 2 was significantly lower than that of group 1 (group 1, 3.4 ± 1.5; group 2, 2.1 ± 1.0; P <.001). VAS pain scores at 6 months or 12 months or at the last follow-up and functional scores and ROM at 3, 6, or 12 months or at the last follow-up were not significantly different between the 2 groups (P > .05). The retear rate of repaired rotator cuff during follow-up was not significantly different between the 2 groups (P = .71).

Corticosteroid injection in the glenohumeral joint performed 2 months after ARCR in RCT patients with stiffness is as effective as capsular release during ARCR for improving the clinical outcome of the operated shoulder.

Level I, prospective randomized clinical trial.

Graves’ disease, a common autoimmune disorder, characteristically presents with upper eyelid retraction, causing significant functional and cosmetic concerns for affected individuals. The management of Graves’ upper eyelid retraction has evolved significantly over recent years, with various surgical and non-surgical interventions. An ideal procedure is predictable and easily repeatable. This review provides a comprehensive overview of the contemporary approaches to managing Graves’ upper eyelid retraction, encompassing both traditional and emerging techniques. It critically evaluates the surgical options for correcting Graves’ upper eyelid retraction to achieve the desired eyelid contour, eyelid crease, tarsal platform show, and brow fat span. Their comparative effectiveness is meticulously explored, offering clinicians valuable insights into treatment selection. Moreover, this review also underscores combined orbital decompression with levator recession. Additionally, advancements in non-invasive modalities, including botulinum toxin, triamcinolone acetate injections, and hyaluronic acid fillers are discussed in detail. This review aims to facilitate informed decision-making and improve the overall outcomes for individuals affected by Graves’ disease-associated upper eyelid retraction.