The Safety of Hip Injection with Corticosteroid in the Diagnosis and Treatment of Osteoarthritis

Abstract

Introduction Injection of steroid and local anaesthetic into hip and knee joints has been a recommended treatment for osteoarthritic pain for decades. There have been recent studies showing a higher incidence of infection leading to early revision of joint prostheses in patients who have had corticosteroid injections prior to joint replacement surgery. Objective The aim of our study was to determine if there is any risk of infection in patients undergoing total hip arthroplasty (THA) after a hip joint injection. Patients and Methods A retrospective search was conducted using the hospital computer database to identify patients who underwent hip injection and subsequent THA between 2000 and 2004. The study included a review all case notes to specifically identify prosthetic infection or early joint replacement surgery. Results One hundred and twenty-eight patients had hip joint injections and subsequently underwent successful total hip replacement. In this study there was no evidence of associated risk of prosthetic infection or early revision of total hip arthroplasty after hip joint injection with corticosteroids (average time of follow-up 3.2 years). Conclusions Hip injection is safe provided a strict aseptic protocol is maintained. The time period of pain relief with hip injection is limited (average 2 months). For diagnostic purposes injections with local anaesthetic only is recommended. A large randomised control study would probably further substantiate these findings.