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Hess SR, O'Connell RS, Bednarz CP, et al. Association of rapidly destructive osteoarthritis of the hip with intra-articular steroid injections. Arthroplast Today. 2018;4(2):205-209doi: 10.1016/j.artd.2017.12.002.
Hess, S. R., O'Connell, R. S., Bednarz, C. P., Waligora, A. C., Golladay, G. J., & Jiranek, W. A. (2018). Association of rapidly destructive osteoarthritis of the hip with intra-articular steroid injections. Arthroplasty today, 4(2), 205-209. https://doi.org/10.1016/j.artd.2017.12.002
Hess, Shane R, et al. "Association of rapidly destructive osteoarthritis of the hip with intra-articular steroid injections." Arthroplasty today vol. 4,2 (2018): 205-209. doi: https://doi.org/10.1016/j.artd.2017.12.002
Hess SR, O'Connell RS, Bednarz CP, Waligora AC, Golladay GJ, Jiranek WA. Association of rapidly destructive osteoarthritis of the hip with intra-articular steroid injections. Arthroplast Today. 2018 May 07;4(2):205-209. doi: 10.1016/j.artd.2017.12.002. eCollection 2018 Jun. PMID: 29896554; PMCID: PMC5994787.
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Arthroplast Today. 2018 May 07;4(2):205-209. doi: 10.1016/j.artd.2017.12.002. eCollection 2018 Jun.

Association of rapidly destructive osteoarthritis of the hip with intra-articular steroid injections.

Arthroplasty today

Shane R Hess, Robert S O'Connell, Christopher P Bednarz, Andrew C Waligora, Gregory J Golladay, William A Jiranek

Affiliations

  1. The CORE Institute, Phoenix, AZ, USA.
  2. Department of Orthopaedic Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA.
  3. Greater Pittsburgh Orthopaedic Associates, Pittsburgh, PA, USA.
  4. Duke University Medical Center, Durham, NC, USA.

PMID: 29896554 PMCID: PMC5994787 DOI: 10.1016/j.artd.2017.12.002

Abstract

BACKGROUND: To assess the relationship between rapidly destructive osteoarthritis (RDOA) of the hip and intra-articular steroid injections.

METHODS: Coding records from 2000 to 2013 were used to identify all subjects who had a fluoroscopy-guided intra-articular hip injection to treat pain associated with primary osteoarthritis. Radiographic measurements from preinjection and postinjection imaging were evaluated with Luquesne's classification of RDOA to determine diagnosis (greater than 50% joint space narrowing or greater than 2 mm of cartilage loss in 1 year with no other forms of destructive arthropathy). Demographic information, health characteristics, and number of injections were collected and analyzed as other potential explanatory variables. Patient outcome assessed by need for total hip arthroplasty (THA) after injection was also recorded.

RESULTS: One hundred twenty-nine injection events met the inclusion criteria in a total of 109 patients. From this sample, 23 cases of RDOA were confirmed representing a 21% incidence of RDOA. Twenty-one of the patients (91%) with RDOA had a THA at a median time of 10.2 months (interquartile range: 6.5-11.2) compared with 27 (31%) of those without RDOA at a median time of 24.9 months (interquartile range: 15.3-65.3). Older patients, patients with more severe osteoarthritis, and patients who identified themselves as white were more likely to have a diagnosis of RDOA (

CONCLUSIONS: The potential for RDOA and faster progression to THA raises questions about the use of intra-articular steroid injections for hip osteoarthritis and should be discussed with patients. Additional studies are needed to define a true relationship.

Keywords: Intra-articular injections; Rapidly destructive osteoarthritis; Steroids; Total hip arthroplasty

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