Intra-articular hip corticosteroid injections do not offer prolonged pain relief or time to THA
For patients with advanced hip osteoarthritis, intra-articular hip corticosteroid injections will not provide a long-term solution for pain or prolong the time to total hip arthroplasty, according to study results.
Musa Zaid, MD, and colleagues from the department of orthopedic surgery at the University of California, San Francisco, separated patients who had primary hip OA from 2014 to 2019 into three groups: patients who received an image-guided hip corticosteroid injection (CSI) before an ipsilateral THA, patients who received the same hip CSI without ensuing THA, and a control group of patients who underwent THA with no history of hip CSI, according to the study abstract.
“This is the first study of its kind to determine if hip injections prolong the time to total hip arthroplasty for patients being evaluated for surgery,” Zaid told Healio Orthopedics.
After evaluating a total of 390 injections (240 CSI with THA, 150 CSI without THA), researchers found that, “patients who underwent an injection only received short-term pain relief, 47 days on average,” Zaid said. “For patients with advanced osteoarthritis, hip injections did not meaningfully prolong the time to hip replacement; patients who underwent a hip injection had surgery, on average, 4 months later than patients who did not have an injection (11.8 months vs. 7.6 months).” Yet, Zaid noted the 4-month difference may be accounted for by the time it took patients to schedule and receive the injection.
Zaid and colleagues also discovered 6.9% of patients who received hip CSI without a subsequent THA found the injections helpful.
Due to the low satisfaction rate, Zaid said CSI injections should only be considered for patients with medical comorbidities or other contraindications who are poor surgical candidates, as the injections themselves come with risk.
“Surgeons should re-consider offering this as a therapeutic option due to the known increased risk of prosthetic joint infections in patients with a history of previous injections,” Zaid said. “Data from this study may impact how surgeons utilize therapeutic intra-articular hip corticosteroid injections for patients with symptomatic hip osteoarthritis who are good surgical candidates.” – by Max R. Wursta
Disclosure: Zaid reports no relevant financial disclosures.
Zaid M, et al. ePaper 016. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2020 (meeting canceled).