osteoarthritis

Hip Injections May Lead to Bone Death, Collapse

Receiving steroid injections in the hip is associated with an increased incidence of bone death and collapse in patients with osteoarthritis (OA), according to a recent study.

Findings from the study were presented on November 29, 2017, at the Radiological Society of North America (RSNA) 2017 103rd Scientific Assembly and Annual Meeting.1
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Steroid and anesthetic injections are common treatments for patients with pain and inflammation in joints such as the hip, knee, or shoulder.

For their study, the researchers evaluated 102 patients who had received steroid injections in the hip, as well as a hip control group (n = 102) who had hip x-rays without a steroid or anesthetic injection and a shoulder injection control group (n = 44) who underwent imaging and received a steroid or anesthetic injection in the shoulder.

All participants had received x-rays of the treated hip at the time of the injection and at follow-up 3 to 9 months post-injection.

Results demonstrated that new osteonecrosis had developed in 22% to 24% of participants who had received hip injections, compared with 5% to 9% in the hip control group and 5% in the shoulder injection control group. Approximately 15% to 17% of patients in the hip injection group had experienced bone collapse in the head of the femur bone, compared with 4% of those in the hip control group and 2% in the shoulder injection control group.

Participants who had received hip injections also had increased imaging findings of OA compared with control groups. However, these differences were not statistically significant.

“We need to look at what's going on with the steroid/anesthetic injectate and osteoarthritis patients to determine what's causing the changes that occur in some patients,” the researchers said in a press release. “However, we don't want to deter patients from getting an injection. These results are enough to warrant an investigation, but not enough to cancel a procedure.”2

—Christina Vogt

Reference:

  1. Chang CY. Hip steroid/anesthetic injections: is there an increase of hip osteoarthritis progression, femoral head osteonecrosis and collapse? Paper presented at: Radiological Society of North America 2017; November 26-December 1, 2017; Chicago, IL. https://press.rsna.org/timssnet/rsna/media/pr2017/chang/abstract/chang.pdf.
  2. Hip steroid injections associated with bone changes [press release]. Chicago, IL. Radiological Society of North America. November 29, 2017. https://press.rsna.org/timssnet/Media/pressreleases/14_pr_target.cfm?id=1971. Accessed November 29, 2017.