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Should I have steroid injections before joint replacement surgery?

Q) I have arthritis in my hip which will require a hip replacement in due course. Would it be possible or advisable to have a steroid injection in the hip while waiting for surgery?
Margery, New Moston, Manchester (Spring 2014)

A) Surgeons, on the whole, don’t like you to have a steroid injection into a joint they are likely to operate on in the near (some say up to six months) future. The reason they give is that injections of steroid may introduce bacteria, or lower the ‘resistance’ of the joint to bacteria, so that there is more chance of the new joint becoming infected after the operation. This is a dreaded complication of artificial joint surgery and something that surgeons will avoid at all costs. Don’t forget that if you have rheumatoid arthritis, rather than osteoarthritis, most people will also taking drugs to lower immunity and this may slightly increase the risk of infection. If you are planning to have a steroid injection while waiting for the operation it is best to check with the surgeon beforehand as I have known surgeons cancel the operation on learning that an injection was carried out in the recent past.

This answer was provided by Dr Philip Helliwell for the Spring 2014 edition of our magazine, Arthritis Today, and was correct at the time of publication.

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