Intra-articular Corticosteroid Injections in the Hip and Knee: Perhaps Not as Safe as We Thought?

Corticosteroid injections: glass half-full, half-empty or full then empty?

“…Although worse outcomes in the cohort study were seen even with a single injection, repeated cortisone injections were associated with greater deterioration than a single injection. A 2019 case series revealed that the risk of medium-term to long-term complications for both knee and hip OAs treated with cortisone injections may be quite high 11…”

A systematic review of injectable corticosteroid for osteoarthritis of the first metatarsophalangeal joint 

“…The severity of 1 st MPJ OA amongst recipients in trials should be classi ed prior to intervention by clinical and radiological examination [19] and a sub group analysis of outcome measures provided according to disease severity. Further research to determine whether treatment outcomes are improved by the use of image guidance, extrapolation of side effects [40] and whether the use of IA CSI in 1 st MPJ reduces surgical burden would be bene cial.…”

Is there a place for intra-articular corticosteroid injections in the treatment of knee osteoarthritis?

“…A retrospective study using a national insurance database in the United States highlights possible increased risk of infection after knee surgery in patients who had received a corticosteroid injection in the same knee within three months before surgery 1112. A recent case series reported adverse joint events on imaging in 8% (36/459) of patients with hip and knee osteoarthritis who had received at least one intra-articular corticosteroid injection in the preceding year 13. This study has several limitations but warrants further investigation into risks of disease worsening.…”