Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 3,
321-323.
doi: 10.1302/0301-620X.88B3.17136
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
Infection in knee replacements after previous injection of intra-articular steroid
A. V. Papavasiliou, BSc, MD, PhD, Research Registrar in Orthopaedics1;
D. L. Isaac, BSc, MS, MRCS Ed, Specialist Registrar in Orthopaedics1;
R. Marimuthu, MRCS Ed, Senior House Officer in Orthopaedics1;
A. Skyrme, FRCS(Orth), Consultant in Trauma and Orthopaedics1; and
A. Armitage, FRCS(Orth), Consultant in Trauma and Orthopaedics1
1 Orthopaedic Department, Eastbourne District General Hospital NHS Trust, Kings Drive, Eastbourne BN21 2UD, UK.
Correspondence should be sent to Dr A. V. Papavasiliou; e-mail: Ppvsl{at}aol.com
We reviewed 231 patients who had undergone total knee replacement with an AGC (Biomet) implant over a period of 2.5 years. After applying exclusion criteria and with some loss to follow-up, there were 144 patients available for study. These were divided into two groups; those who had received intra-articular steroid in the 11 months before surgery and those who had not.
There were three deep infections, all of which occurred in patients who had received a steroid injection. The incidence of superficial infection was not significantly different in the two groups. Five patients had undergone investigation for suspected deep infection because of persistent swelling or pain and all of these had received an intra-articular injection pre-operatively. We conclude that the decision to administer intra-articular steroids to a patient who may be a candidate for total knee replacement should not be taken lightly because of a risk of post-operative deep infection.
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