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Journal of Long-Term Effects of Medical Implants
Do Prior Intra-Articular Corticosteroid Injections or Time of Administration Increase the Risks of Subsequent Periprosthetic Joint Infections after Total Knee Arthroplasty?
Harpal S. Khanuja
Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; George Washington University, Washington, DC
Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD; Department of Orthopaedic Surgery, Johns Hopkins Bayview Medical Center, Johns Hopkins University, Baltimore, MD
Guneet S. Sodhi
Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, MD
Michael A. Mont
Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
Intra-articular injections of corticosteroids have been used as a treatment option for degenerative arthritis of the knee for short- to mid-term symptomatic pain relief for many decades. Recently, there have been studies that have reported increased risks of periprosthetic joint infections in patients who have received these injections. In this study, we evaluated the risk of superficial, deep, and overall rate of infections in 302 patients who had received intra-articular corticosteroid infiltration within 12 months before undergoing total knee arthroplasty (TKA) and compared them with a 1:1 matched cohort who had undergone TKA, but who did not have any prior corticosteroid knee injections. At a mean follow-up of approximately 3.5 years after TKA, there were no significant differences in the rate of superficial incisional infections (7 vs. 6 out of 302 patients), deep periprosthetic infections (3 vs. 6 out of 302 patients), and overall infections (10 vs. 12 out of 302 patients) in the two groups. In addition, no significant differences were found in the rate of deep infections when intra-articular corticosteroids were administered 10 weeks to 2 months, 2−4 months, 4−6 months, 6−12 months, and beyond 12 months before surgery. We concluded that intra-articular corticosteroid injections are safe and do not increase the rate of postoperative infections.
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