Corticosteroid, a drug that suppresses the immune system, is often injected into patients to alleviate pain and inflammation in the months before total joint replacement surgeries, but it may increase the risk for postoperative infection and complications, two studies suggest.
Both studies were presented at the 2016 Annual Meeting of the American Academy of Orthopaedic Surgeons in Orlando, Fla.
The first study focused on preoperative hip injections. Researchers examined data from 177,762 patients collected from the years 2005 to 2012 in the Statewide Ambulatory Surgery and Inpatient Databases from Florida and California. The study attributed injections administered within three months of a THR to a 40 percent increased risk to postoperative infection. This is the first study to deliver evidence of this caliber attributing infection risk to injections delivered inside of 12 weeks before a THR.
Researchers in the second study examined 83,684 patients in the Humana database who underwent total knee replacement for the first time between 2007 and 2014. In this study, 35.4 percent of patients were given an injection within one year prior to TKR. The chances of injected patients incurring a surgical site infection was nearly 1 percent higher than patients who did not receive an injection. The rate of acquiring an infection that would necessitate a return to the operating room was also markedly higher.
"We would recommend being selective when indicating patients for injection, and limiting use of injections to people unlikely to undergo knee replacement in the near future," said lead study author Nicholas Bedard, MD, an orthopedic surgeon at Iowa City-based University of Iowa Hospitals and Clinics. "This information is important not only for orthopedic surgeons, but for all healthcare providers who manage knee arthritis symptoms."
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