Association of rapidly destructive osteoarthritis of the hip with intra-articular steroid injections
Background: To assess the relationship between rapidly destructive osteoarthritis (RDOA) of the hip and intra-articular steroid injections. Methods: Coding records from 2000 to 2013 were used to identify all subjects who had a fluoroscopy-guided intra-articular hip injection to treat pain associated...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-06-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344117301784 |
| _version_ | 1819063237149196288 |
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| author | Shane R. Hess, DO Robert S. O'Connell, MD Christopher P. Bednarz, BS Andrew C. Waligora, IV, MD Gregory J. Golladay, MD William A. Jiranek, MD |
| author_facet | Shane R. Hess, DO Robert S. O'Connell, MD Christopher P. Bednarz, BS Andrew C. Waligora, IV, MD Gregory J. Golladay, MD William A. Jiranek, MD |
| author_sort | Shane R. Hess, DO |
| collection | DOAJ |
| description | Background: To assess the relationship between rapidly destructive osteoarthritis (RDOA) of the hip and intra-articular steroid injections.
Methods: Coding records from 2000 to 2013 were used to identify all subjects who had a fluoroscopy-guided intra-articular hip injection to treat pain associated with primary osteoarthritis. Radiographic measurements from preinjection and postinjection imaging were evaluated with Luquesne's classification of RDOA to determine diagnosis (greater than 50% joint space narrowing or greater than 2 mm of cartilage loss in 1 year with no other forms of destructive arthropathy). Demographic information, health characteristics, and number of injections were collected and analyzed as other potential explanatory variables. Patient outcome assessed by need for total hip arthroplasty (THA) after injection was also recorded.
Results: One hundred twenty-nine injection events met the inclusion criteria in a total of 109 patients. From this sample, 23 cases of RDOA were confirmed representing a 21% incidence of RDOA. Twenty-one of the patients (91%) with RDOA had a THA at a median time of 10.2 months (interquartile range: 6.5-11.2) compared with 27 (31%) of those without RDOA at a median time of 24.9 months (interquartile range: 15.3-65.3). Older patients, patients with more severe osteoarthritis, and patients who identified themselves as white were more likely to have a diagnosis of RDOA (P = .008; P = .040; P = .009, respectively).
Conclusions: The potential for RDOA and faster progression to THA raises questions about the use of intra-articular steroid injections for hip osteoarthritis and should be discussed with patients. Additional studies are needed to define a true relationship. |
| first_indexed | 2024-12-21T15:11:29Z |
| format | Article |
| id | doaj.art-d112e0eb270340ec867aeb4935fe4aad |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-12-21T15:11:29Z |
| publishDate | 2018-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-d112e0eb270340ec867aeb4935fe4aad2022-12-21T18:59:17ZengElsevierArthroplasty Today2352-34412018-06-014220520910.1016/j.artd.2017.12.002Association of rapidly destructive osteoarthritis of the hip with intra-articular steroid injectionsShane R. Hess, DO0Robert S. O'Connell, MD1Christopher P. Bednarz, BS2Andrew C. Waligora, IV, MD3Gregory J. Golladay, MD4William A. Jiranek, MD5The CORE Institute, Phoenix, AZ, USADepartment of Orthopaedic Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USADepartment of Orthopaedic Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USAGreater Pittsburgh Orthopaedic Associates, Pittsburgh, PA, USADepartment of Orthopaedic Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USADuke University Medical Center, Durham, NC, USABackground: To assess the relationship between rapidly destructive osteoarthritis (RDOA) of the hip and intra-articular steroid injections. Methods: Coding records from 2000 to 2013 were used to identify all subjects who had a fluoroscopy-guided intra-articular hip injection to treat pain associated with primary osteoarthritis. Radiographic measurements from preinjection and postinjection imaging were evaluated with Luquesne's classification of RDOA to determine diagnosis (greater than 50% joint space narrowing or greater than 2 mm of cartilage loss in 1 year with no other forms of destructive arthropathy). Demographic information, health characteristics, and number of injections were collected and analyzed as other potential explanatory variables. Patient outcome assessed by need for total hip arthroplasty (THA) after injection was also recorded. Results: One hundred twenty-nine injection events met the inclusion criteria in a total of 109 patients. From this sample, 23 cases of RDOA were confirmed representing a 21% incidence of RDOA. Twenty-one of the patients (91%) with RDOA had a THA at a median time of 10.2 months (interquartile range: 6.5-11.2) compared with 27 (31%) of those without RDOA at a median time of 24.9 months (interquartile range: 15.3-65.3). Older patients, patients with more severe osteoarthritis, and patients who identified themselves as white were more likely to have a diagnosis of RDOA (P = .008; P = .040; P = .009, respectively). Conclusions: The potential for RDOA and faster progression to THA raises questions about the use of intra-articular steroid injections for hip osteoarthritis and should be discussed with patients. Additional studies are needed to define a true relationship.http://www.sciencedirect.com/science/article/pii/S2352344117301784Rapidly destructive osteoarthritisTotal hip arthroplastyIntra-articular injectionsSteroids |
| spellingShingle | Shane R. Hess, DO Robert S. O'Connell, MD Christopher P. Bednarz, BS Andrew C. Waligora, IV, MD Gregory J. Golladay, MD William A. Jiranek, MD Association of rapidly destructive osteoarthritis of the hip with intra-articular steroid injections Arthroplasty Today Rapidly destructive osteoarthritis Total hip arthroplasty Intra-articular injections Steroids |
| title | Association of rapidly destructive osteoarthritis of the hip with intra-articular steroid injections |
| title_full | Association of rapidly destructive osteoarthritis of the hip with intra-articular steroid injections |
| title_fullStr | Association of rapidly destructive osteoarthritis of the hip with intra-articular steroid injections |
| title_full_unstemmed | Association of rapidly destructive osteoarthritis of the hip with intra-articular steroid injections |
| title_short | Association of rapidly destructive osteoarthritis of the hip with intra-articular steroid injections |
| title_sort | association of rapidly destructive osteoarthritis of the hip with intra articular steroid injections |
| topic | Rapidly destructive osteoarthritis Total hip arthroplasty Intra-articular injections Steroids |
| url | http://www.sciencedirect.com/science/article/pii/S2352344117301784 |
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