Timing of Intra-Articular Injections in Joint Replacement INTRODUCTION Total joint arthroplasty is a successful treatment that improves joint function, relieves pain, and increases the overall quality of life and is...
Timing of Intra-Articular Injections in Joint Replacement INTRODUCTION Total joint arthroplasty is a successful treatment that improves joint function, relieves pain, and increases the overall quality of life and is becoming increasingly popular. It is important for a sports medicine or orthopedic physician to be aware of the data regarding timing of intra-articular injections and their risk of infection with subsequent procedures. Most practices do offer intra-articular injections in many joints with the most common being the knee, hip and glenohumeral joint.
Being aware of the preferences of the joint replacement surgeons is also valuable for relationships with your colleagues. Many patients do have a schedule or ideal time to go through a joint replacement and it is important to not cause any undue risks or delays in treatment. Case Vignette A 66 year old football coach reports to your office with right knee discomfort over the past year.
He has a history of ACL reconstruction when he was in his 30s. He is debating on getting a knee injection to help with his pain and asks you about risk factors for osteoarthritis. Which of the following is NOT a risk factor for osteoarthritis?
A) Female age greater than 55 B) Obesity C) Family history of osteoarthritis D) Male age greater than 50 HIP Intra-articular hip injections are becoming more common with the increased usage of ultrasound-guided injections. Blind injections have been shown to be somewhat unreliable with roughly 60 percent accuracy. For this reason, many are sent to have this performed under fluoroscopy or ultrasound guidance.
A study by Kaspar and de Beer in 2005 reported an increased risk of infections in patients receiving an intra-articular hip injection before total hip arthroplasty (12/40) compared to control (3/40). This created debate among orthopedic providers and many studies have been performed since then. Reported rates of infection of 0% in the experimental group and 1.4% in controls.
If you are experiencing symptoms that may be related to timing of intra-articular injections before joint replacement, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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