Patients Receiving Steroid Injections Prior to Total Joint Arthroplasty

Steroid injections have become popular for the treatment of symptoms in advanced osteoarthritis (OA). These interventions have demonstrated to provide a temporary relief of pain in patients with moderate-to-severe OA who are not willing or suitable for a total joint arthroplasty (TJA). On the other hand, systemic adverse events associated with intra-articular injections are infrequent [1]. As a consequence of this positive balance, steroid injections are recommended as a part of the therapeutic approach in patients suffering from osteoarthritis by several international guidelines [2–5] with a strong level of recommendation. Due to this wide acceptance, it has been documented that a significant proportion of patients undergoing total knee arthroplasty have received at least one intra-articular injection before surgery. However, some concerns remain in regard to the association of preoperative administration of these treatments and the risk of surgical site infection after total hip or knee arthroplasty. This association could be the result of direct inoculation of microorganisms during injection or the immunosuppressive effect of the corticosteroid, or both.