INFECTED TOTAL HIP REPLACEMENTS AFTER STEROIDS

S. Kaspar; J. deBeer

doi:10.1302/0301-620X.87BSUPP_III.0870363

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INFECTED TOTAL HIP REPLACEMENTS AFTER STEROIDS

S. Kaspar
J. deBeer

INFECTED TOTAL HIP REPLACEMENTS AFTER STEROIDS

Kaspar S, deBeer J. INFECTED TOTAL HIP REPLACEMENTS AFTER STEROIDS. Orthop Procs. 2005;87-B(SUPP_III):363-363. doi:10.1302/0301-620X.87BSUPP_III.0870363

Kaspar, S., and J. deBeer. “INFECTED TOTAL HIP REPLACEMENTS AFTER STEROIDS.” Orthopaedic Proceedings, vol. 87-B, no. SUPP_III, 2005, pp. 363-363., https://doi.org/10.1302/0301-620X.87BSUPP_III.0870363

Kaspar, S., & deBeer, J. (2005). INFECTED TOTAL HIP REPLACEMENTS AFTER STEROIDS. Orthopaedic Proceedings, 87-B(SUPP_III), 363-363. https://doi.org/10.1302/0301-620X.87BSUPP_III.0870363

Kaspar, S. and deBeer, J. (2005) “INFECTED TOTAL HIP REPLACEMENTS AFTER STEROIDS.” Orthopaedic Proceedings, 87-B(SUPP_III), pp. 363-363. Available at: https://doi.org/10.1302/0301-620X.87BSUPP_III.0870363

Kaspar, S., and J. deBeer. “INFECTED TOTAL HIP REPLACEMENTS AFTER STEROIDS.” Orthopaedic Proceedings 87-B, no. SUPP_III (2005): 363-363. https://doi.org/10.1302/0301-620X.87BSUPP_III.0870363

Kaspar S, deBeer J. INFECTED TOTAL HIP REPLACEMENTS AFTER STEROIDS. Orthop Procs. 2005 Sep 1;87-B(SUPP_III):363-363. https://doi.org/10.1302/0301-620X.87BSUPP_III.0870363

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Abstract

Introduction and Aims: Intra-articular steroid hip injection (IASHI) for osteoarthritis of the hip has not been well studied. The immunosuppressive nature of steroids may be hypothesised to interfere with asepsis in subsequent total hip arthroplasty (THA). We evaluate the infectious complications and functional outcomes of THA performed in patients who previously received IASHI.

Method: This is a retrospective cohort study of functional outcomes (Harris and Oxford hip scores), and infectious complications in the first year following THA, in patients without (n=40 controls) or with (n=40) a history of ipsilateral IASHI. Functional scores had been compiled in our database, at one tertiary care centre, and infectious complications (wound infection, deep infection, work-up with bone scans, revision surgery) were retrospectively reviewed from hospital records.

Results: The IASHI group had worse post-THA function (p=0.0008 ANOVA for Oxford functional hip scores across time, with mean one-year scores being worse by seven points out of 60). In the IASHI group there were five revision surgeries, four of which were for deep infection of the hip replacement (10%, versus 0% in controls, versus 1.02% in our database of 979 THA primaries, p < 0.001 by Log-Rank testing of Kaplan-Meier survivor-ship analysis). Additionally, each group had two superficial wound infections. Six additional IASHI patients underwent infectious work-ups for ongoing hip problems (compared to one patient worked-up in the control group). The total rate of culture-proven infection (either superficial or deep), or problems leading to negative infectious work-up, was 12/40 (steroid, 30%) versus 3/40 (control, 7.5%, p = 0.010 by Fisher’s Exact test).

Conclusion: IASHI should now be considered as relatively contra-indicated in patients who are (or will become) candidates for THA. IASHI appears to compromise the functional results of subsequent THA, with much higher infection and revision rates. We suggest a multi-centre review of infected THA post-IASHI.

These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.

At least one of the authors is receiving or has received material benefits or support from a commercial source.