Do intra-articular steroid injections increase infection rates in subsequent arthroplasty? A systematic review and meta-analysis of comparative studies

J Arthroplasty. 2014 Nov;29(11):2175-80. doi: 10.1016/j.arth.2014.07.013. Epub 2014 Aug 2.


Intra-articular steroid injections are widely used in joint arthritis. The safety of such injections has been questioned as they may increase infection rates in subsequent arthroplasty. We carried out a meta-analysis of studies examining the relation between intra-articular steroid injections and infection rates in subsequent joint arthroplasty. A literature search was undertaken. Eight studies looking at hip and knee arthroplasties were analyzed. Meta-analysis showed that steroid injection had no significant effect on either deep (risk ratio = 1.87; 95% CI 0.80-4.35; P = 0.15) or superficial infection rates (risk ratio = 1.75; 95% CI 0.76-4.04; P = 0.19) of subsequent arthroplasty. Further large cohort studies would be of value in further examining whether steroid injections close to the time of arthroplasty are safe.

Keywords: arthroplasty; infection; injections; intra-articular; steroid.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Arthritis, Gouty
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Cohort Studies
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / adverse effects*
  • Humans
  • Injections, Intra-Articular / adverse effects*
  • Joint Diseases / surgery
  • Prosthesis-Related Infections / etiology*


  • Glucocorticoids