Small Joint Arthroplasty and Arthrodesis Complications After Corticosteroid Injections

Corticosteroid injections (CSIs) have demonstrated efficacy in reducing pain and improving function for patients with arthritic and inflammatory pathology in the upper extremity. However, reports remain rare regarding the association of CSIs in the hand and postoperative complications. The purpose of this study was to assess the risk of postoperative complications after small joint arthroplasty and arthrodesis in patients who received preoperative CSIs in that joint before surgery.

A retrospective review was performed of patients who underwent arthrodesis or arthroplasty of the distal interphalangeal (DIP) joint, proximal interphalangeal (PIP) joint, metacarpophalangeal (MP) joint, or thumb interphalangeal (IP) joint from January 2009 to December 2023. Variables collected included patient demographics, medical history, operative details, CSI history, and complications. The relationship between patient factors, CSI history, and postoperative complications was assessed.

A total of 192 joints in 115 patients were included in the analysis. Seventy-two (37.5%) small joints underwent arthroplasty, while 120 (62.5%) received arthrodesis. Twenty (10.4%) small joints received CSIs before operative management, and 9 (4.7%) received CSIs within 6 months of surgery. A total of 50 (26.0%) joints experienced complications, with 3 (1.6%) joints experiencing surgical site infections and 6 (3.1%) with nonunion. Analyses did not suggest a higher risk for complications in patients who received CSIs in the hand before arthroplasty or arthrodesis.

CSIs within 6 months of hand arthrodesis or arthroplasty did not result in significantly higher complication rates, suggesting that CSIs can be performed safely before operative management of small joint arthritis.