Sunday, December 1, 2019

Steroid injections - the risk of infections

Preoperative corticosteroid joint injections within 2 weeks of shoulder arthroscopies increase postoperative infection risk

These authors assessed the relationship between preoperative corticosteroid injection timing and shoulder arthroscopy infectious outcomes using an insurance database to identify and sort all shoulder arthroscopy patients by corticosteroid shoulder injection history within 6 months before surgery.

They identified 50,478 shoulder arthroscopy patients, of whom 4115 received injections in the 6-month preoperative period. They found a significant increase in both the overall infection rate (P < .0001) and severe infection rate (P < .0001) in patients who received injections within 2 weeks before surgery (n = 79; 8.86% and 6.33%, respectively) compared with those who received no injections in the 6-month preoperative period (n = 46,363; 1.56% and 0.55%, respectively). 

Comment: The risk of infection with shoulder arthroscopy should be low. Here we see a dramatic increase in the rate of infection in those patients having steroid injections within two weeks of the procedure. 

It is reasonable to suspect a similar increase in risk of infections in shoulder arthroplasties performed within 2 weeks of an injection.

It would have been interesting to know what bacteria caused these injections, but those data are not available.

We have a new set of shoulder youtubes about the shoulder, check them out at this link.

Be sure to visit "Ream and Run - the state of the art" regarding this radically conservative approach to shoulder arthritis at this link and this link

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