Pereira L C, Kerr J, Jolles B M
Centre Hospitalier Universitaire Vaudois, Site Hôpital Orthopédique, Avenue Pierre Decker 4, CH-1011 Lausanne, Switzerland.
Therap-ease Treatment Centre, 382 Morningside Road, Edinburgh, EH10 5HX, UK.
Bone Joint J. 2016 Aug;98-B(8):1027-35. doi: 10.1302/0301-620X.98B8.37420.
Using a systematic review, we investigated whether there is an increased risk of post-operative infection in patients who have received an intra-articular corticosteroid injection to the hip for osteoarthritis prior to total hip arthroplasty (THA).
Studies dealing with an intra-articular corticosteroid injection to the hip and infection following subsequent THA were identified from databases for the period between 1990 to 2013. Retrieved articles were independently assessed for their methodological quality.
A total of nine studies met the inclusion criteria. Two recommended against a steroid injection prior to THA and seven found no risk with an injection. No prospective controlled trials were identified. Most studies were retrospective. Lack of information about the methodology was a consistent flaw.
The literature in this area is scarce and the evidence is weak. Most studies were retrospective, and confounding factors were poorly defined or not addressed. There is thus currently insufficient evidence to conclude that an intra-articular corticosteroid injection administered prior to THA increases the rate of infection. High quality, multicentre randomised trials are needed to address this issue. Cite this article: Bone Joint J 2016;98-B:1027-35.
通过系统评价，我们调查了在全髋关节置换术（THA）前因骨关节炎接受髋关节内皮质类固醇注射的患者术后感染风险是否增加。
从1990年至2013年期间的数据库中识别出有关髋关节内皮质类固醇注射及随后THA后感染的研究。对检索到的文章进行独立的方法学质量评估。
共有9项研究符合纳入标准。两项研究建议在THA前不进行类固醇注射，7项研究发现注射无风险。未识别出前瞻性对照试验。大多数研究是回顾性的。缺乏关于方法学的信息是一个常见缺陷。
该领域的文献稀缺且证据薄弱。大多数研究是回顾性的，混杂因素定义不明确或未得到解决。因此，目前没有足够的证据得出THA前进行髋关节内皮质类固醇注射会增加感染率的结论。需要高质量、多中心随机试验来解决这个问题。引用本文：《骨与关节杂志》2016年；98-B：1027 - 35。
