Infection in knee replacements after previous injection of intra-articular steroid

• Published in: Journal of bone and joint surgery. British volume Vol. 88; no. 3; pp. 321 - 323
• Main Authors: PAPAVASILIOU, A. V, ISAAC, D. L, MARIMUTHU, R, SKYRME, A, ARMITAGE, A
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01.03.2006; British Editorial Society of Bone & Joint Surgery
• Edition: British volume
• Subjects: Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; Arthroplasty, Replacement, Knee; Biological and medical sciences; Diseases of the osteoarticular system; Female; Humans; Injections, Intra-Articular - adverse effects; Knee Prosthesis - adverse effects; Male; Medical sciences; Middle Aged; Orthopedic surgery; Osteoarthritis, Knee - complications; Osteoarthritis, Knee - surgery; Prosthesis-Related Infections - chemically induced; Prosthesis-Related Infections - drug therapy; Retrospective Studies; Steroids - administration & dosage; Steroids - adverse effects; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Knee; Infection; Steroid; Orthopedic surgery; Treatment
• ISSN: 0301-620X; 2049-4394; 2044-5377; 2049-4408
• DOI: 10.1302/0301-620X.88B3.17136

We reviewed 231 patients who had undergone total knee replacement with an AGC (Biomet) implant over a period of 2.5 years. After applying exclusion criteria and with some loss to follow-up, there were 144 patients available for study. These were divided into two groups; those who had received intra-articular steroid in the 11 months before surgery and those who had not. There were three deep infections, all of which occurred in patients who had received a steroid injection. The incidence of superficial infection was not significantly different in the two groups. Five patients had undergone investigation for suspected deep infection because of persistent swelling or pain and all of these had received an intra-articular injection pre-operatively. We conclude that the decision to administer intra-articular steroids to a patient who may be a candidate for total knee replacement should not be taken lightly because of a risk of post-operative deep infection.