Injections prior to hip arthroscopy are associated with increased risk of repeat hip arthroscopy at 1 and 5 years

Johnson, Andrea H.; Brennan, Jane C.; Maley, Alyssa; Levermore, Sandra B.; Turcotte, Justin J.; Petre, Benjamin M.

doi:10.1007/s00402-023-05164-7

Cited by 1 publication

(1 citation statement)

References 35 publications

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“…Johnson et al [ 7 ] compared the odds of repeat hip arthroscopy, total hip arthroplasty (THA), infection, and new-onset osteoarthritis (OA) at one and five years following hip arthroscopy among patients receiving a prior corticosteroid injection, local anesthetic injection, or no injection. They found no significantly greater odds of infection, THA, or new-onset OA between any injection versus no injection, corticosteroid injection versus no injection, local anesthetic injection versus no injection, and corticosteroid injection versus local anesthetic injection at both one and five years post surgery.…”

Section: Reviewmentioning

confidence: 99%

Postoperative Infection Following Hip Arthroscopy in Patients Receiving Preoperative Intra-articular Injections: A Systematic Review and Meta-Analysis

Aamer,

Tokhi,

Asim

et al. 2024

Cureus

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Intra-articular injections prior to hip arthroscopy are often used to diagnose and conservatively manage hip pathologies, such as femoroacetabular impingement, labral tears, and chondral lesions. As a diagnostic tool, the relief of hip pain following an intra-articular injection helps pinpoint the primary source of pain and assists surgeons in recommending arthroscopic intervention for underlying intra-articular pathologies. However, when injections are not sufficiently spaced apart in time prior to hip arthroscopy, there is an elevated risk of postoperative infection. This systematic review aims to assess whether preoperative intra-articular injections prior to hip arthroscopy are associated with an increased risk of postoperative infection and to determine the safety timeframe for administering such injections prior to the procedure. A comprehensive search was conducted in the PubMed, Embase, and Cochrane Library databases to identify studies examining the relationship between preoperative intra-articular injections and postoperative infection following hip arthroscopy. A meta-analysis was conducted to compare the risk of infection between patients who received injections prior to hip arthroscopy at varying intervals and those who did not receive any preoperative injections. Five studies were included (four level III and one level IV), which consisted of 58,576 patients (58.4% female). Injections administered anytime prior to hip arthroscopy posed a significantly higher risk of infection compared to no history of prior injections (risk ratio: 1.45, 95% confidence interval: 1.14-1.85, P = 0.003). However, upon subanalysis, the risk of infection was significantly higher among patients who received injections within three months prior to hip arthroscopy compared to those who did not receive injections (risk ratio: 1.55, 95% confidence interval: 1.19-2.01, P = 0.001). Additionally, no significant difference in infection risk was observed when injections were administered more than three months before hip arthroscopy compared to no injections (risk ratio: 1.05, 95% confidence interval: 0.56-1.99, P = 0.87). The findings suggest that patients undergoing hip arthroscopy who have previously received intra-articular injections may face a statistically higher risk of postoperative infection, particularly when the injection is administered within three months prior to hip arthroscopy. Consequently, surgeons should exercise caution and avoid administering intra-articular injections to patients scheduled for hip arthroscopy within the subsequent three months to mitigate the increased risk of infection.

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Section: Reviewmentioning

confidence: 99%