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Outcomes After Diagnostic Hip Injection.

T Sean Lynch1, Michael E Steinhaus2, Charles A Popkin3

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Summary
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Diagnostic hip injections offer significant pain relief for various hip conditions. However, non-response to these injections strongly predicts poor surgical outcomes, highlighting their predictive value for operative success.

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Area of Science:

  • Orthopedic surgery
  • Pain management
  • Diagnostic procedures

Background:

  • Diagnostic hip injections using local anesthetic (LA) or LA with corticosteroid (CS) are utilized to assess pain sources.
  • Predicting surgical success based on injection response remains an area of interest.

Purpose of the Study:

  • To comprehensively review outcomes of diagnostic hip injections (LA or LA/CS).
  • To evaluate the predictive value of injection response for subsequent operative success.

Main Methods:

  • Systematic review of English-language studies from database inception to January 2015.
  • Exclusion of studies with >50% osteoarthritis; data collected by two independent reviewers.

Main Results:

  • Seven studies included 337 patients; mean age 34.4 years.
  • Pain relief varied: LA (92.5%), CS (61%-82.3%). Duration of relief longer with CS (9.8 days) vs. LA (2.35 days).
  • Acetabular chondral injury showed greatest relief (93.3%); cam impingement least (81.6%). Clinical/imaging findings were unreliable predictors; non-response predicted negative surgical outcome for femoroacetabular impingement.

Conclusions:

  • Diagnostic hip injections provide substantial pain relief across pathologies.
  • Non-response is a strong negative predictor of surgical success.
  • Further research needed on pathology-specific differences and predicting operative outcomes.