Assessing Patient Characteristics That Prolong the Need for Total Hip Arthroplasty Following Surgeon-Administered...

Although intra-articular corticosteroid hip injections may only delay an inevitable surgery, patient-specific factors and individual psychosocial factors that might dissuade immediate surgery are not fully understood. The purpose of this study was to understand the diverse reasons that patients elect to undergo hip injections and the various timelines to total hip arthroplasty (THA).

A retrospective review was conducted at a single academic medical center identifying all consecutive patients who had undergone fluoroscopically guided intra-articular surgeon-administered corticosteroid hip injections between June 2018 and February 2023. Data collected included baseline demographics, hip radiographic variables, duration of postinjection pain relief, and if THA was performed. Univariate and multivariate logistic regression analyses identified predictors associated with undergoing THA within 6 and 12 months postinjection.

A total of 93 patients (22 bilateral) with average age of 59.8 ± 1.6 years and body mass index of 31.0 ± 6.3 kg/m2 were reviewed. Reasons for hip injection included the following: 39% due to fear or anxiety of THA; 33% for diagnostic purposes, primarily to discern if the pain stemmed from another source such as the lumbar spine or knee. Most patients showed advanced osteoarthritis: 44% Kellgren-Lawrence (K-L) grade 3 and 35% K-L grade 4. After injection, the average reported pain relief duration was 3.8 ± 4.9 months. Smoking markedly increased the likelihood of undergoing THA within 6 months (OR = 10.889; P = 0.001) and 12 months (OR = 6.375; P = 0.008).

This study elucidated the multifaceted reasons patients opt for conservative management through corticosteroid hip injections. The value of patient-centered care is emphasized in managing hip osteoarthritis, as shown in the high patient retention rates postinjection.