Intraarticular Injections Before Total Knee Arthroplasty: Risk Factor for Infection?

For patients with knee osteoarthritis, orthopedic guidelines recommend against intraarticular hyaluronic acid injections and note that evidence for steroid injections is inconclusive (NEJM JW Gen Med Jul 15 2018 and J Bone Joint Surg Am 2018; 100:827). Nevertheless, many patients continue to receive these interventions. In this retrospective study, researchers used an insurance-derived database to examine whether intraarticular injections during the year before total knee arthroplasty (TKA) were a risk factor for periprosthetic joint infection.

Of 58,000 patients who underwent TKA, 29% received steroids and 6% received hyaluronic acid during the year before TKA. Periprosthetic infections during the 6 months after TKA were diagnosed in 4.2%, …