Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 May 7;4(2):205-209.
doi: 10.1016/j.artd.2017.12.002. eCollection 2018 Jun.

Association of rapidly destructive osteoarthritis of the hip with intra-articular steroid injections

Shane R Hess  1 , Robert S O'Connell  2 , Christopher P Bednarz  2 , Andrew C Waligora 4th  3 , Gregory J Golladay  2 , William A Jiranek  4
Affiliations

Association of rapidly destructive osteoarthritis of the hip with intra-articular steroid injections

Shane R Hess et al. Arthroplast Today. .

Abstract

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.

Keywords: Intra-articular injections; Rapidly destructive osteoarthritis; Steroids; Total hip arthroplasty.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flowchart for patient selection process.
Figure 2
Figure 2
(a) Sixty-year-old woman with left hip pain; (b) 1 month after receiving a left hip intra-articular steroid injection.
See this image and copyright information in PMC

References

    1. Forestier F. 1957. Coxite rhumatismales subaigues et chnoniques. [Thesis]. Paris.
    1. Delia Torre P., Picuti G., Di Filippo P. Rapidly progressive osteoarthritis of the hip. Ital J Orthop Traumatol. 1987;13:187. - PubMed
    1. Lequesne M. Rapid destructive coxarthritis. Rhumatologie. 1970;22:51. - PubMed
    1. Kellgren J.H., Lawrence J.S. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16:494. - PMC - PubMed
    1. Rosenberg Z.S., Shankman S., Steiner G.C., Kastenbaum D.K., Norman A., Lazansky M.G. Rapid destructive osteoarthritis: clinical, radiographic, and pathologic features. Radiology. 1992;182:213. - PubMed

LinkOut - more resources