Does Surgical Approach in Total Hip Arthroplasty Affect Postoperative Corticosteroid Injection Requirements?

Area of Science:

• Orthopedic Surgery
• Musculoskeletal Health

Background:

• Corticosteroid injections are frequently used post-total hip arthroplasty (THA) to manage soft tissue issues like bursitis and tendinitis.
• Surgical approach in THA influences muscle and soft tissue dissection, potentially affecting outcomes.

Purpose of the Study:

• To compare the impact of anterior versus posterior surgical approaches on the requirement for postoperative corticosteroid injections after THA.
• To identify patient and surgical risk factors associated with receiving different types of postoperative injections.

Main Methods:

• A propensity-matched retrospective study of 10,907 THA patients was conducted.
• Patients were stratified by anterior or posterior surgical approach and propensity-matched 1:1.
• Multivariate logistic regression analyzed factors influencing postoperative steroid injections.

Main Results:

• The posterior approach was associated with a significantly increased risk of postoperative injections (aOR 1.242, P=0.001).
• Higher rates of greater trochanteric bursitis injections were observed after the posterior approach (11.5% vs 7.3%).
• A history of preoperative injection was the strongest predictor for postoperative injections (aOR 3.772, P<0.001).

Conclusions:

• Posterior approach, female sex, and prior corticosteroid injection history are key risk factors for postoperative injections, especially for greater trochanteric bursitis.
• These factors are crucial for patient counseling regarding expected outcomes and injection likelihood after THA.