A Steroid Injection for Bone-on-Bone Arthritis? Not So Fast!

Sometimes, arthritis gets so bad that nothing seems to help, and people decide they are ready for joint replacement surgery. When that time comes, some patients are surprised to learn they will have to wait a few months because they recently had an injection of a steroid or hyaluronic acid. Waiting is not the only issue. The injections do little to relieve pain when someone has bone-on-bone arthritis and is a candidate for joint replacement. If there is any pain relief at all, it is very short-lived, and most patients are very disappointed.

The other issue is that patients who receive a steroid or hyaluronic acid injection should wait approximately three months from the date of their last injection to have a hip or knee replacement. This is because studies have demonstrated an increased risk of infection in the first three months following these injections. 


When elective surgeries resumed after the pandemic pause, I saw five patients over a two-week period whose joint replacement was delayed due to an injection. All were understandably upset that the physician who prescribed or gave them the injection did not inform them they would have to wait three months to have the surgery.

With respect to steroid injections in particular, there is another serious problem. Studies have shown that repeated shots of corticosteroids actually cause more destruction in the joint by accelerating damage to cartilage.

Hip and knee replacements are common and safe procedures that relieve pain and improve quality of life, and overall, the risk of developing an infection is very low. But since it is one of the most serious complications a patient can have after surgery, it is important to let enough time go by after an injection. As long a patient waits three months from their last injection, there is no increased risk at all.

Educated patients who take an active role in their care and ask good questions have the best chance to receive the right treatment for their condition.

 


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