Corticosteroid injections within 4 weeks of RSA associated with increased risk of PJI
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Result showed intra-articular corticosteroid shoulder injections within 4 weeks of reverse shoulder arthroplasty are associated with increased risks of periprosthetic joint infection at 90-days and 1-year postoperatively.
Researchers used the PearlDiver database to perform a retrospective cohort study of patients who received an intra-articular corticosteroid injection (CSI) into the shoulder at various timeframes prior to RSA. Researchers analyzed five cohorts: 5,607 patients who received a CSI within 4 weeks of RSA; 3,024 patients who received a CSI 1 to 2 months prior to RSA; 1,572 patients who received a CSI 2 to 3 months prior to RSA; 16,302 patients who received a CSI more than 3 months prior to RSA; and a control cohort of 21,938 patients who received no CSI prior to RSA.
Researchers found a 9.4% incidence of PJI at 90 days in patients who received a CSI within 4 weeks of RSA compared with a 7.2% incidence of PJI at 90 days in patients who received no CSI. They also found patients who received a CSI within 4 weeks of RSA had an increased risk of PJI at 1-year postoperatively compared with the other cohorts. No significant increase in incidence of PJI was noted for patients who received a CSI more than 4 weeks before RSA.
“The present study suggests 4 weeks is the critical period after CSI in which RSA should not be performed as to reduce postoperative PJI risk,” the researchers wrote in the study. “Additionally, alcohol abuse, chronic kidney disease and depression were identified as risk factors for PJI with CSI,” they wrote.
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