Does intra-articular steroid injection increase the risk of infection in primary total hip arthroplasty?

Clin Orthop Relat Res. 2012 May 19.
Meermans G, Corten K, Simon JP.
Intra-articular injection of the hip is performed for diagnostic and therapeutic purposes. Damage to the articular cartilage and an increased risk of infection of the implant in total hip arthroplasty have been reported as possible risks following such injections. However, the literature contains conflicting reports on the increased risk of infection of a total hip arthroplasty. The aim of this study was therefore to investigate the possible risk of infection of a total hip arthroplasty following steroid injection.
The records of 175 patients who had received intra-articular steroid injections under strictly aseptic conditions, by a lateral approach, within the year before their total hip arthroplasty were reviewed retrospectively. These patients were compared with other patients in the database who had not received a steroid injection.
No differences were found in the rate of deep and superficial infections between the two groups. One patient in the injection group and one in the control group developed a delayed chronic infection. In three patients in the injection group and one in the control group, one of the intraoperative cultures was positive. Five patients in the injection group and seven in the control group developed superficial infections. Seven patients in the injection group and five in the control group had prolonged discharge from the surgical wound for more than 5 days. None of these patients had a deep infection at the latest follow-up.
The authors of the study concluded that, when strictly aseptic conditions are used, intra-articular injection of the hip does not increase the risk of infection in patients who subsequently undergo total hip arthroplasty.