Metz Allan K, Rainey Joshua P, Blackburn Brenna E, Taylor Adam J, Peters Christopher L
Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah.
J Arthroplasty. 2025 Aug;40(8S1):S68-S71.e1. doi: 10.1016/j.arth.2025.03.037. Epub 2025 Mar 19.
The value of intra-articular corticosteroid injections (CSI) in the treatment of hip osteoarthritis has come into question due to concerns regarding efficacy and complication profile. This study aimed to assess patient satisfaction after CSI for hip osteoarthritis and the association of CSI with potential complications following subsequent total hip arthroplasty (THA).
A survey was sent to 510 patients who received at least one CSI before THA. Data collected included reduction in visual analog scale pain scores, duration of relief, and patient satisfaction. A retrospective review of 1,090 THA patients at our institution was performed to evaluate the association of CSI to potential complications following THA. Chi-square, Fisher exact, and logistic regression were used for comparison between groups. A total of 104 patients, who had injections in 129 hips, responded (response rate 20.4%); there was 45.8% of patients who had one injection per hip, with a mean of 2.2 injections per hip (range, one to 10).
Patients reported a mean reduction in visual analog scale pain scores of 5.2 (SD = 3.2), with the average relief lasting 6.2 weeks (SD = 8.4). Of note, 16.5% reported no satisfaction after CSI, and 44.4% stated they would not undergo CSI again. Of the 1,090 THA patients that were retrospectively reviewed, 247 patients (22.7%) received a CSI before THA; this was associated with an increased rate of septic revision (2.0 versus 0.5%, odds ratio = 4.98, P = 0.014). There were no significant differences in aseptic revision rates (P = 0.28).
Almost half of the patients who received a CSI before THA would not do so again, with average pain relief lasting approximately 6 weeks. Given the increased risk of septic revision for those who underwent CSI before THA, this draws further concern regarding the value of CSI before THA.
由于对疗效和并发症情况的担忧，关节内注射皮质类固醇（CSI）治疗髋骨关节炎的价值受到质疑。本研究旨在评估髋骨关节炎患者接受CSI后的满意度以及CSI与随后全髋关节置换术（THA）后潜在并发症的关联。
向510例在THA前至少接受过一次CSI的患者发送调查问卷。收集的数据包括视觉模拟量表疼痛评分的降低、缓解持续时间和患者满意度。对本机构1090例THA患者进行回顾性研究，以评估CSI与THA后潜在并发症的关联。采用卡方检验、Fisher精确检验和逻辑回归进行组间比较。共有104例患者（129髋接受注射）做出回应（回应率20.4%）；45.8%的患者每髋注射一次，平均每髋注射2.2次（范围为1至10次）。
患者报告视觉模拟量表疼痛评分平均降低5.2（标准差=3.2），平均缓解持续6.2周（标准差=8.4）。值得注意的是，16.5%的患者在接受CSI后表示不满意，44.4%的患者表示不会再次接受CSI。在1090例接受回顾性研究的THA患者中，247例（22.7%）在THA前接受了CSI；这与感染性翻修率增加相关（2.0%对0.5%，优势比=4.98，P=0.014）。无菌性翻修率无显著差异（P=0.28）。
几乎一半在THA前接受CSI的患者不会再次接受，平均疼痛缓解持续约6周。鉴于THA前接受CSI的患者感染性翻修风险增加，这进一步引发了对THA前CSI价值的关注。
