Hip Intra-articular Injection

Abstract

Osteoarthritis is a common, debilitating progressive disease that commonly affects the hips (Choueiri M, Chevalier X, Eymard F. Intraarticular Corticosteroids for Hip Osteoarthritis: A Review. Cartilage. 2021 Dec;13(1_suppl):122S-131S). Progression of osteoarthritis often results in the need for total arthroplasty of the hip. First-line treatments include oral acetaminophen and nonsteroidal anti-inflammatory drugs. Intra-articular corticosteroid injections are routinely performed for patients with refractory pain or dysfunction, or for those with contraindications to long-term systemic treatment with acetaminophen or nonsteroidal anti-inflammatories. The goal in managing osteoarthritis with intra-articular corticosteroid injections is to provide pain relief, improvement in function, and to delay the need for arthroplasty. This is thought to be achieved via decreasing the inflammation in the joint by the corticosteroids (Choueiri M, Chevalier X, Eymard F. Intraarticular Corticosteroids for Hip Osteoarthritis: A Review. Cartilage. 2021 Dec;13(1_suppl):122S-131S).

Evidence suggests that intra-articular injections can be helpful to relieve pain and improve function in the short term, however the long-term safety and effects on the progression of osteoarthritis are unclear (Choueiri M, Chevalier X, Eymard F. Intraarticular Corticosteroids for Hip Osteoarthritis: A Review. Cartilage. 2021 Dec;13(1_suppl):122S-131S). A growing body of evidence has suggested accelerated rates of osteoarthritis progression, whereas other studies find no significant difference in progression of joint destruction (Zeng et al., Osteoarthritis Cartilage 27(6):855–62, 2019). Intra-articular corticosteroid injections remain one of the most common treatments for osteoarthritis of the hip, and it is important for the treating pain physician to weigh the risks and benefits with each patient.