This abstract reproduced courtesy of The Journal of Arthroplasty.

The Timing of Total Hip Arthroplasty After Intraarticular Hip Injection Affects Postoperative Infection Risk

Brian C. Werner, MD, Jourdan M. Cancienne, MD, James A. Browne, MD

Department of Orthopaedic Surgery, University of Virginia Health System, Box 800159, Charlottesville, Virginia

DOI: http://dx.doi.org/10.1016/j.arth.2015.08.032

Background

The data regarding any association between preoperative intraarticular steroid injection and risk of periprosthetic joint infection (PJI) after total hip arthroplasty (THA) are conflicting. The goal of the present study is to evaluate the association of preoperative intraarticular hip injection before THA on the incidence of postoperative PJI.

Methods

A national database was queried for patients who underwent THA and those patients who underwent prior ipsilateral hip injection. Three cohorts were created: THA within 3 months of ipsilateral hip injection (n = 829), THA between 3 and 6 months after ipsilateral hip injection (n= 1379), and THA between 6 and 12months after ipsilateral hip injection (n=1160). A control group of THA without prior injection was created for comparison purposes (n=31,229). The rate of postoperative infectionwas compared between injection cohorts and controls.

Results

The incidence of infection after THA at 3 months (2.41%; odds ratio, 1.9; P = .004) and 6 months (3.74%; odds ratio, 1.5; P < .019) was significantly higher in the patients who underwent hip injection within 3months before THA compared with controls. There was no significant difference in infection rates in patients who underwent THA between 3 and 6months or 6 and 12months after ipsilateral hip injection compared with controls.

Conclusions

The present study demonstrates a significant increase in PJI in patients who underwent intraarticular hip injection within 3 months before THA. This association was not noted when THA was more than 3 months after injection.