Corticosteroid Injections Administered Within 4 Weeks Prior to Hip Arthroscopy Are Associated With Higher Rates of Postoperative Infection.

Autor:	Surucu S; Department of Orthopaedics and Rehabilitation, Yale University, New Haven, Connecticut, U.S.A.. Electronic address: serkansurucu@outlook.com., Halperin SJ; Department of Orthopaedics and Rehabilitation, Yale University, New Haven, Connecticut, U.S.A., Monahan PF; Penn State College of Medicine, Hershey, Pennsylvania, U.S.A., Gillinov SM; Department of Orthopaedics and Rehabilitation, Yale University, New Haven, Connecticut, U.S.A., Lee MS; Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A., Grauer JN; Department of Orthopaedics and Rehabilitation, Yale University, New Haven, Connecticut, U.S.A., Jimenez AE; Department of Orthopaedics and Rehabilitation, Yale University, New Haven, Connecticut, U.S.A.
Jazyk:	angličtina
Zdroj:	Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association [Arthroscopy] 2024 Sep; Vol. 40 (9), pp. 2381-2385.e1. Date of Electronic Publication: 2024 Feb 02.
DOI:	10.1016/j.arthro.2024.01.016
Abstrakt:	Purpose: To evaluate the association between the timing of intra-articular hip corticosteroid injections and the risk of postoperative infection in patients undergoing hip arthroscopy. Methods: The 2010-2021 PearlDiver M157 administrative claims database was queried for patients who underwent hip arthroscopy. Patients who received intra-articular corticosteroid injections within 12 weeks prior to arthroscopy were matched 1:1 to patients who did not receive such injections based on age, sex, and Elixhauser Comorbidity Index, as well as the presence of diabetes mellitus, hypertension, obesity, and tobacco use. Those with injections prior to arthroscopy were subdivided based on having received injections within 12 weeks prior to surgery. To verify that the corticosteroid injections and surgical procedures were conducted in the hip joint, Current Procedural Terminology codes were used. By use of Current Procedural Terminology and International Classification of Diseases (ninth revision and tenth revision) coding, postoperative surgical-site infection after corticosteroid injection was evaluated. The impact of the timing of preoperative corticosteroid injections on the incidence of postoperative infection was evaluated using multivariable logistic regression analysis. Results: A total of 12,390 hip arthroscopy cases were identified, including 3,579 patients who received corticosteroid injections 0 to 4 weeks prior to surgery; 4,759, within 4 to 8 weeks prior to surgery; and 4,052, within 8 to 12 weeks prior to surgery. Compared with controls, patients who received corticosteroid injections within 0 to 4 weeks preoperatively had a significantly higher rate of surgical-site infection (odds ratio, 2.43; P = .0001). No significant differences in infection rates were observed at the later time intervals (4-8 weeks or 8-12 weeks). Furthermore, in comparison to controls, patients who received corticosteroid injections had a significantly higher rate of wound dehiscence (odds ratio, 1.84; P = .0007). Conclusions: Intra-articular corticosteroid injections within 4 weeks prior to hip arthroscopy were significantly associated with increased surgical-site infection rates after hip arthroscopy surgery. Level of Evidence: Level III, retrospective comparative study. Competing Interests: Disclosures The authors report the following potential conflicts of interest or sources of funding: A.E.J. receives grants from Arthrex, outside the submitted work. All other authors (S.S, S.J.H., P.F.M., S.M.G., M.S.L., J.N.G.) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Full ICMJE author disclosure forms are available for this article online, as supplementary material. (Copyright © 2024 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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