Steroid Injections Before Knee Replacement Increases Risk of Complications

By Chris Centeno, MD /

Receive a Regenexx® Patient Info Packet by email and learn why it's a superior regenerative solution.

steroid shot joint replacement

We’ve known for a long time now that injecting high-dose steroids into arthritic or painful knees is a dumb idea. Now, new research shows that if a patient who gets a steroid injection goes on to get a knee replacement, they are at higher risk for a complication. I’ll review in a moment, but first, let’s talk about steroids.

Why Steroids for Knee Pain and Arthritis?

Each year, millions of patients receive steroid injections for knee pain and arthritis as well as pain and swelling in many other musculoskeletal structures; in fact, corticosteroid injections are the most common injections given for pain and swelling not just in the U.S. but worldwide. While steroids may be a powerhouse drug that can temporarily relieve pain and swelling, unfortunately, the high-dose steroids that are typically injected can be toxic to cells and other body tissues.

In addition, while that first shot may seem to miraculously eliminate your pain, the effect is only temporary, and with each subsequent steroid shot, that pain relief typically diminishes. There’s also a question as to whether steroids really are the powerhouse drugs they get credit for as many studies suggest the relief provided after a steroid injection is actually due to the anesthetic used with the steroid, not the steroid itself. Research has also found that there’s no significant improvement in knee pain and arthritis when comparing a steroid injection with a placebo, and the patients receiving steroid injections experienced twice the amount of cartilage loss when compared to those receiving the placebo.

Steroid Injections and Hip or Knee Replacement Are a Bad Combo

The purpose of the new study was to determine what factors put arthritis patients undergoing joint replacement, such as knee or hip replacement, at a higher risk for complications and infections following surgery. The study consisted of 1,150 joint replacement patients, and comorbidities and treatments prior to surgery were determined as well as complications following surgery.

Results from the study (table 2, page 5) show that you are 2.14 times as likely to get a complication after joint replacement if you’ve had a steroid injection. This makes steroid injections one of the biggest risks for complications (only having a respiratory problem, anemia, a mental illness, or rheumatoid arthritis was worse). In addition, you are also 3.16 times as likely to get an infection if you’ve had steroid injections and then have a joint replacement. Why? Steroids inhibit the immune system, and what is the job of the immune system? To fight infections!

Steroids, Hip Replacements, and Infection Risks: The Links Are Well Established

This isn’t the first time we’ve seen links between steroids, hip replacements, and infection risks. I’ve covered a few studies in the past showing that steroid injections in the hip are associated with higher infection rates when followed by hip replacement. For example, when comparing hip replacement patients who had steroid shots prior to surgery to hip replacement patients who did not, surgical infection risk in the steroid group increased by 37%. Even more telling, there was a 53% increased risk for hip replacement failure that resulted in a second hip replacement, and the primary reason for this was an infection. The problem isn’t just limited to steroid injections; oral steroid use has also been linked to joint infections following hip replacement and other joint replacements.

The upshot? Steroids are used like holy water out there, so you need to be an educated patient to avoid being a victim of this common, but clearly misguided medical practice. What can you try instead? A PRP (platelet-rich plasma) shot has no known side effects and may actually help rather than destroy the cartilage in the joint. It may cost you some out-of-pocket expense, but, thankfully, it likely won’t wreck your joint if you need a replacement down the road.

 

Category: Uncategorized

Leave a Reply

Your email address will not be published. Required fields are marked *

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
View Profile

Get Blog Updates by Email

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
Select Your Problem Area
Shoulder

Shoulder

Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.

  • Rotator Cuff Tears and Tendinitis
  • Shoulder Instability
  • SLAP Tear / Labral Tears
  • Shoulder Arthritis
  • Other Degenerative Conditions & Overuse Injuries
Learn More
Cervical Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Knee

Knees

Knees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis.

  • Knee Meniscus Tears
  • Knee ACL Tears
  • Knee Instability
  • Knee Osteoarthritis
  • Other Knee Ligaments / Tendons & Overuse Injuries
  • And more
Learn More
Lower Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Hand & Wrist

Hand & Wrist

Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Hand and Wrist Arthritis
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb)
  • Other conditions that cause pain
Learn More
Elbow

Elbow

Most injuries of the elbow’s tendons and ligaments, as well as arthritis, can be treated non-surgically with regenerative procedures.

  • Golfer’s elbow & Tennis elbow
  • Arthritis
  • Ulnar collateral ligament wear (common in baseball pitchers)
  • And more
Learn More
Hip

Hip

Hip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures.

  • Labral Tear
  • Hip Arthritis
  • Hip Bursitis
  • Hip Sprain, Tendonitis or Inflammation
  • Hip Instability
Learn More
Foot & Ankle

Foot & Ankle

Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Ankle Arthritis
  • Plantar fasciitis
  • Ligament sprains or tears
  • Other conditions that cause pain
Learn More

Is Regenexx Right For You?

Request a free Regenexx Info Packet

REGENEXX WEBINARS

Learn about the #1 Stem Cell & Platelet Procedures for treating arthritis, common joint injuries & spine pain.

Join a Webinar

RECEIVE BLOG ARTICLES BY EMAIL

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Subscribe to the Blog

FOLLOW US

Copyright © Regenexx 2019. All rights reserved. | Privacy Policy

*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.