english.prescrire.org > Spotlight > Archives : 2022 > Intra-articular corticosteroids: risk of rapid destruction of the hip joint

Spotlight: Archives

Every month, the subjects in Prescrire’s Spotlight.

2022 : 1 | 30 | 60

Intra-articular corticosteroids: risk of rapid destruction of the hip joint

Injection of corticosteroids into the hip joint is aimed at reducing pain and delaying the need for hip replacement. It is possible that, in some patients, these injections cause a rapid exacerbation of their condition.

In 2021, using the database of a US health insurance and health care organisation, a team carried out two epidemiological studies to investigate the association between intra-articular injection of corticosteroids into the hip joint and the onset of rapidly destructive hip disease.

A case-control study compared exposure to intra-articular hip injections of triamcinolone in 40 patients having rapidly destructive hip disease, with exposure in 717 patients who underwent total hip arthroplasty for another indication. The patients with rapidly destructive hip disease had been exposed to triamcinolone hip joint injections 8 times more often than the patients not having rapidly destructive hip disease. This risk appeared to be dose-dependent and was particularly marked following injection of 80 mg or more of triamcinolone.

In a cohort of 610 patients who had received one or more injections of corticosteroid into the hip joint, 37 patients (5.4%) developed rapid destruction of the articular cartilage.

Between 2015 and 2018, in parallel with a reduction in the number of these intra-articular injections, there was a reduction in the number of cases of rapidly destructive hip disease, from whatever cause, whereas the number of total hip replacements remained stable.

Corticosteroids are known to cause tendon and bone damage. Injection of corticosteroids into the hip joint is aimed at reducing pain and delaying the need for hip replacement. According to these data, it is possible that in some patients these injections cause a rapid exacerbation of their condition.

©Prescrire 1 July 2022

Source: "Intra-articular corticosteroids: rapid destruction of the hip joint" Prescrire International 2022; 31 (239): 191. Subscribers only.

Enjoy full access to Prescrire International, and support independent information
Share
Share on Facebook Share on Twitter


See also:

"Corticosteroid injections:
serious infections
and necrosis"
Prescrire Int 2013;
22 (134): 17.
Pdf, free


Read more:

All the subjects in
Prescrire's Spotlight
Free >