Prevalence of Rapidly Progressive Osteoarthritis of the Hip following Intra-articular Steroid Injections.
Academic Article
Overview
abstract
INTRODUCTION: Numerous studies have indicated that intra-articular steroid injections to the hip are beneficial for their ability to offer short-term pain relief. However, recent studies have drawn concerns that the injections may cause rapidly progressive osteoarthritis of the hip (RPOH) following intra-articular steroid injections. The prevalence of RPOH following intra-articular steroid injections varies widely in the literature. OBJECTIVE: To identify the prevalence of RPOH following intra-articular steroid injections, and to compare baseline characteristics between patients with and without RPOH. DESIGN: Case series. SETTING: Tertiary academic hospital PATIENTS: 924 patients (median[IQR] age: 59[45-70] years; 579 females) who received an intra-articular hip steroid/anesthetic injection from January 2016 to March 2018 and had available pre- and post-injection imaging (prior to surgical intervention) were included in the study. INTERVENTIONS: Baseline and injection-related data, including demographics, age, body mass index, medical history, laterality, and steroid type, were collected from electronic medical records. MAIN OUTCOME MEASURES: Post-injection RPOH was determined via imaging review by a physiatry fellow, followed by an attending physiatrist and a musculoskeletal radiologist to confirm findings. RESULTS: The majority of patients received unilateral injections into the hip, and the most common steroids used were triamcinolone and methylprednisolone. Review of pre- and post-injection imaging revealed 26 cases of RPOH, for an overall prevalence of 2.8% (95% CI: 1.9%-4.1%). Compared to those without RPOH, patients with RPOH were significantly older (median[IQR]: 64[60-73] vs. 59[44-70] years, p=0.003) and had a shorter duration of symptoms prior to their injections (median[IQR]: 3[1-6] vs. 12[6-36] months, p<0.001). Adjusted regression analyses showed that age was associated with greater odds of RPOH (OR[95% CI]: 1.04[1.01, 1.07]; p=0.003). CONCLUSIONS: The prevalence of RPOH following intra-articular steroid injections into the hip was lower than previously reported but still clinically relevant. This should be considered when counseling patients prior to intra-articular hip steroid injections. This article is protected by copyright. All rights reserved.
