CORR Insights^®: The John N. Insall Award: Do Intraarticular Injections Increase the Risk of Infection After TKA?

Excerpt

Nearly 27 million people are affected by osteoarthritis in the United States alone. Choosing an appropriate treatment plan for patients with this condition can be a challenge [8]. The spectrum of treatment ranges from nonoperative treatment including nonsteroidal medication, analgesics, weight loss, physical therapy and intraarticular injections, to surgical intervention, such as TKA for the arthritic knee. Many patients, desiring to avoid surgery, choose nonoperative care. It has been reported that up to 30% of patients undergoing a TKA will have an intraarticular corticosteroid injection prior to surgery [1, 9]. Despite the frequent use of intraarticular corticosteroid injections, there are no surgeon guidelines regarding the timing and the safety of injections prior to TKA. While many surgeons recommend a delay between intraarticular injection and surgery, there is conflicting information about whether injections before surgery increase the risk of infection afterwards [9, 10], and if so, what a safe waiting period might be between an injection and the eventual TKA [1]. …