Jourdan M Cancienne1, Brian C Werner2. 1. Southern Orthopaedic Specialists, New Orleans, USA. 2. Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, USA.
Abstract
BACKGROUND: There is little literature examining the association of corticosteroid injections into shoulders with a pre-existing arthroplasty. The aim of the current study was to determine the risk of early infection following intra-articular corticosteroid injection into a pre-existing shoulder arthroplasty. METHODS: The PearlDiver database was retrospectively reviewed to identify patients with a pre-existing shoulder arthroplasty from 2007 to 2017. Patients with an ipsilateral shoulder corticosteroid injection in the postoperative period were identified. A control group of patients without an injection was matched 4:1 by age, gender, and postoperative timepoint. Periprosthetic infection within six months after the injection was then assessed and compared using a logistic regression analysis. RESULTS: Nine hundred and fifty-eight patients were identified who underwent a postoperative corticosteroid injection into a pre-existing shoulder arthroplasty and compared to 3832 control patients. After controlling for demographics, comorbidities, and procedure type, the rate of infection in patients who received a postoperative corticosteroid injection (1.77%) was significantly higher than control patients who did not receive an injection (0.91%) (OR 1.98 (95% CI 1.31-2.98), p = 0.0253). CONCLUSIONS: There is a significant association between intra-articular shoulder corticosteroid injections in patients with pre-existing shoulder arthroplasties and prosthetic joint infection compared to matched controls without postoperative injections. STUDY DESIGN: Level III, retrospective cohort study.
BACKGROUND: There is little literature examining the association of corticosteroid injections into shoulders with a pre-existing arthroplasty. The aim of the current study was to determine the risk of early infection following intra-articular corticosteroid injection into a pre-existing shoulder arthroplasty. METHODS: The PearlDiver database was retrospectively reviewed to identify patients with a pre-existing shoulder arthroplasty from 2007 to 2017. Patients with an ipsilateral shoulder corticosteroid injection in the postoperative period were identified. A control group of patients without an injection was matched 4:1 by age, gender, and postoperative timepoint. Periprosthetic infection within six months after the injection was then assessed and compared using a logistic regression analysis. RESULTS: Nine hundred and fifty-eight patients were identified who underwent a postoperative corticosteroid injection into a pre-existing shoulder arthroplasty and compared to 3832 control patients. After controlling for demographics, comorbidities, and procedure type, the rate of infection in patients who received a postoperative corticosteroid injection (1.77%) was significantly higher than control patients who did not receive an injection (0.91%) (OR 1.98 (95% CI 1.31-2.98), p = 0.0253). CONCLUSIONS: There is a significant association between intra-articular shoulder corticosteroid injections in patients with pre-existing shoulder arthroplasties and prosthetic joint infection compared to matched controls without postoperative injections. STUDY DESIGN: Level III, retrospective cohort study.
Authors: Brian C Werner; Jourdan M Cancienne; M Tyrrell Burrus; Justin W Griffin; F Winston Gwathmey; Stephen F Brockmeier Journal: J Shoulder Elbow Surg Date: 2015-11-30 Impact factor: 3.019
Authors: Jourdan M Cancienne; Stephen F Brockmeier; Lawrence V Gulotta; David M Dines; Brian C Werner Journal: J Bone Joint Surg Am Date: 2017-04-19 Impact factor: 5.284