Published in:
01-09-2019 | Osteoarthrosis | Scientific Article
Are patients more likely to have hip osteoarthritis progression and femoral head collapse after hip steroid/anesthetic injections? A retrospective observational study
Published in: Skeletal Radiology | Issue 9/2019
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Objective
To evaluate progression of osteoarthritis and femoral head articular surface collapse in hip steroid/anesthetic injection patients (HIPs).
Materials and methods
This study was IRB-approved and HIPAA-compliant. Two musculoskeletal radiologists performed retrospective, blinded reviews of radiography for 70 HIPs (40 mg triamcinolone/4 mL 0.5% preservative-free ropivacaine) with a 3- to 10-month follow-up and two control groups: demographic-matched patients with similar hip radiograph follow-up duration but no injection; and glenohumeral joint injection patients. Discordant evaluations were adjudicated by a third, senior reader. Groups were compared using Fisher’s exact and unpaired t tests.
Results
There were 70 HIPs (mean age 67 ± 17 (range 19–92) years; 44 women, 26 men), who were followed for a mean of 6 ± 2 (3–12) months. Thirty-one (31 out of 70, 44%) of HIPs had progression of osteoarthritis after injection, versus 17 out of 70 (24%) of hip controls (HCs) and 13 out of 44 (30%) of glenohumeral injection patients (GIPs). This difference between HIPs and HCs was statistically significant (p = 0.02) but not that between HIPs and GIPs (0.17). Twelve (12 out of 70, 17%) HIPs had new collapse, compared with 1 out of 70 (1%) of HCs and 1 out of 44 (2%) of GIPs. This difference was statistically significant (HCs: p = 0.002; GIPs: p = 0.02).
Conclusion
Hip steroid/anesthetic injection patients are more likely to demonstrate osteoarthritis progression and femoral head collapse than HC and GIPs in the injected joint 3–12 months after steroid and anesthetic injection. Further evaluation of hip injectates and the injection population is warranted.