INFECTION IN PRIMARY TOTAL KNEE ARTHROPLASTY AFTER PRIOR STEROID INFILTRATION

Abstract

To assess the incidence of infection in cases of Primary Total Knee Arthroplasty with prior steroid injection into the knee joint.

Steroid injection into the arthritic joint is a well-known modality of treatment of arthritic joints. Its efficacy is well-documented. Increased incidence of infection secondary to steroid injection as compared to uninjected joints is reported in recent literature.

A retrospective study was conducted. Four hundred and forty patients underwent Total Knee Replacement by the senior author during 1997–2005 at Wrightington hospital. Ninety patients had intraarticular steroid injection prior to surgery of which 35 patients had injection within 1 year prior to surgery. All patients had at least one year follow-up. Infection rate was assessed by case note, x-rays and microbiology review till last follow-up. One hundred and eighty patients of matched cohort who had Total Knee Replacement without steroid injection were compared for infection rate.

Two cases of superficial infection were noted in the infection group and 5 cases of superficial infection in the non-injection group. No case of deep infection was noted in either group. Statistical analysis showed no significant difference in incidence of infection in either group.

Steroids are useful adjuncts in the management of patients with arthritic joints. This study shows no increased incidence of infection in patients who were given steroid injection prior to arthroplasty.