Efficacy of intraarticular corticosteroid hip injections for osteoarthritis and subsequent surgery

ObjectiveOur study aimed to determine the duration of pain relief from intraarticular hip corticosteroid injections and identify patient predictive factors on injection response. We also sought to determine the subsequent rate of hip surgery and whether severity of hip osteoarthritis or injection response correlated with the decision to undergo surgery.Materials and methodsAll intraarticular hip steroid injections performed for osteoarthritis under fluoroscopic guidance at a single institution between January 2010 to December 2012 were retrospectively reviewed. Response was divided into three groups: no relief, immediate (2weeks of pain relief), and continued (> 2weeks of pain relief). Presence of hip surgery for osteoarthritis performed within 2years following injection was obtained. Correlation between patient characteristics with injection outcome and hip surgery was analyzed.ResultsOf 78 patients, a total of 82 injections were analyzed. For injections, 19.5% (16/82) showed no response, 47.6% (39/82) showed immediate response, and 32.9% (27/82) showed continued response. There was no significant correlation between injection outcome with age, Tonnis grade, BMI, or duration of symptoms. In total, 48.7% had hip surgery within 2years after initial injection. There was a significant association between Tonnis grade and surgery, with higher Tonnis grades correlating with decision to undergo surgery (p=0.002).ConclusionsGender, age, BMI, duration of symptoms, and radiographic severity of disease do not predict injection response. Due to high surgical rates and poor response, intraarticular hip steroid injections may be less effective in the long term, and surgical management may be considered earlier.