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Preoperative Corticosteroid Injection Timing and Revision Risk After Midfoot Arthrodesis.

Vidushan Nadarajah1, Jibraun Emerson1, Kate Panzer1

  • 1Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA.

Foot & Ankle International
|January 27, 2026
PubMed
Summary
This summary is machine-generated.

Timing of corticosteroid injections before midfoot fusion impacts outcomes. Injections within 3 months increase 1-year revision risk, but 90-day complications are similar. Careful planning is advised.

Keywords:
arthrodesiscomplicationscorticosteroid injectioninjection timingmidfoot fusionrevision surgery

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Area of Science:

  • Orthopedic Surgery
  • Pharmacology
  • Biostatistics

Background:

  • Midfoot osteoarthritis (OA) often precedes surgical fusion.
  • Intraarticular corticosteroid injections are common before midfoot arthrodesis.
  • The optimal timing for these injections is not well-defined.

Purpose of the Study:

  • To evaluate the association between corticosteroid injection timing and postoperative outcomes.
  • To assess 90-day complications and 1-year revision rates after midfoot arthrodesis based on injection timing.

Main Methods:

  • Retrospective cohort study of 82,144 patients undergoing midfoot arthrodesis (2015-2024).
  • Patients grouped by timing of preoperative corticosteroid injection: ≤1 month, >1-2 months, >2-3 months, ≥3 months (reference), and no injection.
  • Multivariable logistic regression and Cox proportional hazards models analyzed outcomes.

Main Results:

  • Adjusted 90-day complication odds were similar across all injection timing groups compared to the ≥3 months reference.
  • Injections within 3 months of surgery were linked to a significantly higher hazard of 1-year revision (HRs ~1.25-1.49) versus the ≥3 months group.
  • Older age, male sex, and higher comorbidity burden also increased revision risk.

Conclusions:

  • Preoperative corticosteroid injections within 3 months of midfoot arthrodesis correlate with higher 1-year revision rates.
  • No significant difference in 90-day complications was observed based on injection timing.
  • Findings suggest timing-related risks may influence preoperative planning for midfoot fusion, but require cautious interpretation due to data limitations.