Cortisone injections for hip and knee pain can be riskier than previously believed, study says

Hip and knee intra-articular corticosteroid injections, which are quite commonly given to treat joint pain, may be more harmful than medical professionals previously thought, according to new study from the Boston University School of Medicine.

The research team at BUSM found that intra-articular corticosteroid injections can be dangerous for patients with at-risk conditions or may cause complications that aren’t yet fully understood, such as accelerated arthritis and joint destruction, which can necessitate knee or hip replacements.

Their research was published in the journal Radiology Tuesday.

“We are now seeing these injections can be very harmful to the joints with serious complications such as osteonecrosis, subchondral insufficiency fracture and rapid progressive osteoarthritis,” said corresponding author Ali Guermazi, MD, PhD, chief of radiology at VA Boston Healthcare System and professor of radiology at BUSM.

When the researchers identified all the patients whom they had given intra-articular corticosteroid injections in the hip or knee during 2018, they found that 10 percent had complications in the hips and an additional four percent had complications in their knees.

A new study from Boston University School of Medicine found that cortisone shots in the hip and knee may be more dangerous than doctors previously thought and their use may merit more caution. (BSIP/UIG Via Getty Images)

The complications included stress fracture, progressive osteoarthritis and joint collapse.Osteoarthritis, which results from the wearing down of protective cartilage in the joints and the most common form of arthritis, is commonly treated with intra-articular corticosteroid injections, and the practice has become increasingly more common.

BUSM’s new research suggests that the radiologic community needs to do invest more time and resources into high-quality research to gain a better grasp of which conditions place patients at higher risk of complications and to better understand the complications following themselves.

“Intra-articular corticosteroid injection should be seriously discussed for pros and cons. Critical considerations about the complications should be part of the patient consent which is currently not the case right now,” Guermazi said.

He hopes that BUSM’s research will inspire more caution among doctors and patients alike as they consider treating hip or knee pain with intra-articular corticosteroids.

This story was reported from Los Angeles.