Introduction
Numerous studies have indicated that intra‐articular steroid injections to the hip are beneficial for short‐term pain relief. However, recent studies have drawn concerns of 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
A total of 924 patients (median [interquartile range; IQR] age: 59 [45‐70] years; 579 female) 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% confidence interval [CI] 1.9%‐4.1%). Compared to those without RPOH, patients with RPOH were significantly older (median age [IQR]: 64 [60‐73] vs. 59 [44‐70] years, p = .003) and had a shorter duration of symptoms prior to their injections (median [IQR]: 3 vs. 12 [6‐36] months, p < .001). Adjusted regression analyses showed that age was associated with greater odds of RPOH (odds ratio [OR], 95% CI: 1.04, 1.01 to 1.07; p = .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.
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