Epsom and St Helier, UK.
St George's University of London, UK.
Foot (Edinb). 2023 Sep;56:102001. doi: 10.1016/j.foot.2023.102001. Epub 2023 Mar 15.
Intra-articular corticosteroid injections (ICSI) are commonly used in orthopedic practice. Due to concerns about their immunosuppressive effects, we conducted a prospective observational audit, to monitor for COVID-19 infection amongst a group of foot and ankle patients who received an ICSI during the pandemic.
Included were 68 patients (25 males - 43 females, mean age 59.1 years, SD 15.0, range 19 - 90 years) who received a fluoroscopy-guided ICSI within a two-month period during the pandemic. The American Society of Anaesthesiologists (ASA) grade was I in 35 % of patients, II in 58 % and III in 7 %. 16 % of patients had black, Asian or minority ethnic (BAME) background. The dose of methylprednisolone injected was 20 mg for 28 % of the patients, 40 mg for 29 % and 80 mg for 43 %.
All patients were available for follow up at one and four weeks post-injection. None reported COVID-19 infection symptoms within this period. The only complication was a flare-up of joint pain.
Our study showed that the risk of COVID-19 infection to patients receiving foot or ankle ICSI is low. The limitations of this work must be considered, but our findings support the judicious use of corticosteroid injections during the current crisis.
关节内皮质类固醇注射（ICSI）在骨科实践中被广泛应用。由于担心其免疫抑制作用，我们进行了一项前瞻性观察性审计，以监测在大流行期间接受 ICSI 的一组足部和踝关节患者中 COVID-19 感染的情况。
共纳入 68 名患者（25 名男性-43 名女性，平均年龄 59.1 岁，标准差 15.0，范围 19-90 岁），他们在大流行期间的两个月内接受了透视引导下的 ICSI。35%的患者美国麻醉医师协会（ASA）分级为 I 级，58%为 II 级，7%为 III 级。16%的患者有黑人、亚裔或少数族裔（BAME）背景。注射的甲基强的松龙剂量为 20mg 的占 28%，40mg 的占 29%，80mg 的占 43%。
所有患者在注射后 1 周和 4 周均可进行随访。在此期间，没有患者报告 COVID-19 感染症状。唯一的并发症是关节疼痛加剧。
我们的研究表明，接受足部或踝关节 ICSI 的患者感染 COVID-19 的风险较低。必须考虑本研究的局限性，但我们的研究结果支持在当前危机期间合理使用皮质类固醇注射。
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