Intra-articular steroid hip injection for osteoarthritis: a survey of orthopedic surgeons in Ontario.
BACKGROUND
Intra-articular steroid hip injection (IASHI) has been prescribed for painful hip arthritis since the 1950s, but with advances in medical and surgical management its role is less certain today. There are very few published data on the utility or prescribing patterns of IASHI.


METHODS
We developed a questionnaire to seek expert opinion on IASHI that we distributed to practising Ontario-based members of the Canadian Orthopaedic Association. We systematically describe the current practices and expert opinion of 99 hip surgeons (73% response rate), focusing on indications, current use and complications experienced with IASHI.


RESULTS
Only 56% of surgeons felt that IASHI was therapeutically useful, with 72% of surgeons estimating that 60% or less of their patients achieved even transient benefit from IASHI. One-quarter of the surgeons believe that IASHI accelerates arthritis progression, most of whom had stated that it would be no great loss if IASHI was no longer available. Nineteen percent of the surgeons believed that the infection rate related to total hip arthroplasty (THA) may be increased after IASHI, and this was associated with fewer IASHIs ordered per year, compared with the number prescribed by those who did not feel that infection rates would increase.


CONCLUSIONS
This systematic collection of expert opinions demonstrates that substantial numbers of surgeons felt that, in their patients, IASHI was not therapeutically helpful, may accelerate arthritis progression or may cause increased infectious complications after subsequent THA.
Kaspar
John
J
Hamilton Arthroplasty Group, Hamilton Health Sciences, Henderson Hospital Site and McMaster University, Hamilton, Ontrio.
Kaspar
Sam
S
Orme
Cinzia
C
de Beer
Justin de V
Jde V
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy*; D001291:Attitude of Health Personnel; D005260:Female; D019538:Health Care Surveys; D006621:Hip Joint / Q000187:drug effects; D006801:Humans; D007270:Injections, Intra-Articular / Q000592:standards / Q000639:trends; D008297:Male; D009864:Ontario; D009985:Orthopedics / Q000592:standards* / Q000639:trends; D015207:Osteoarthritis, Hip / Q000175:diagnosis / Q000188:drug therapy*; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000639:trends; D011787:Quality of Health Care; D011795:Surveys and Questionnaires
D000305:Adrenal Cortex Hormones