Biologic injections may cause infection, inflammatory reactions
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Treatment with biologic injections may lead to serious complications, such as infections requiring multiple surgical procedures and inflammatory reactions, according to published results.
Claire D. Eliasberg, MD, and colleagues contacted physician members of the Biologic Association to identify patients who received a biologic injection, sustained an adverse reaction and had a minimum of 1-year follow-up after the injection. Researchers recorded patient demographic information, medical comorbidities, diagnoses and prior treatments, and collected the type of injection, injection setting, injection manufacturers and specific details about the complication and outcome.
Across six institutions in the United States, researchers identified 14 patients who met inclusion criteria. Results showed intra-articular knee injections were the most common injections in the series (received by 50% of patients), followed by intra-articular shoulder injections (received by 21.4% patients), while the most common underlying diagnosis was osteoarthritis (in 78.5% of patients). Researchers found the types of injections included umbilical cord blood, platelet-rich plasma, bone marrow aspirate concentrate, placental tissue and unspecified “stem cell” injections. For complications, 50% of patients experienced infection, 42.9% experienced suspected sterile inflammatory response and 7.1% experienced a combination of both, according to results. Results also showed Escherichia coli was the most common pathogen identified from infection cases. Researchers noted treatment with at least one subsequent surgical intervention and IV antibiotic therapy was performed on all patients with isolated infections.
“This study demonstrates that there are serious complications, including infections and inflammatory reactions, that can occur following biologic therapeutic injections utilized for orthopedic purposes,” Eliasberg told Healio Orthopedics. “There are limitations to this study, as 14 patients represent only a small number of patients, and we were certainly unable to capture an exhaustive list of the complications that have arisen nationwide. However, we believe that this data is important for patients and physicians to understand that not all biologic injections are benign and that more research is necessary to better elucidate the efficacy and complication profile following these treatments.”
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