Ipsilateral Preoperative Corticosteroid Injection and Timing Not Associated With Postoperative Deep Infection After...

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Infectious Disease Epidemiology

Background:

• Existing literature suggests a potential increased risk of postoperative infection following corticosteroid injection (CSI) before carpal tunnel release (CTR).
• The precise timing of this potential risk remains unclear.
• This study investigates the association between preoperative CSI timing and postoperative deep infection (PDI) rates.

Purpose of the Study:

• To determine if CSI within 90 days before CTR is associated with higher PDI rates.
• To evaluate if the timing of CSI (0-30, 31-60, or 61-90 days prior to CTR) influences PDI risk.

Main Methods:

• A large administrative claims database (PearlDiver M170) was utilized to identify patients undergoing CTR.
• Patients receiving ipsilateral CSI within 90 days before CTR were matched with controls who did not receive CSI.
• Matched cohorts were analyzed for PDI rates, with CSI timing further stratified into 0-30, 31-60, and 61-90 day intervals.

Main Results:

• Analysis of 17,125 matched patients in each cohort revealed no significant increase in PDI risk for patients who received preoperative CSI compared to controls.
• Stratified analysis by CSI timing (0-30, 31-60, 61-90 days) also showed no notable increase in PDI risk relative to controls.

Conclusions:

• Preoperative corticosteroid injections before carpal tunnel release are not associated with an increased risk of postoperative deep infection at any studied time point.
• These findings contrast with some existing literature and may inform surgical decision-making regarding non-surgical and surgical treatment options for carpal tunnel syndrome.