Outcomes of Total Knee Arthroplasty With Simultaneous Contralateral Knee Intra-articular Corticosteroid Injection

Corticosteroid injections are a nonoperative management option for patients with osteoarthritis (OA) of major joints. Joshy et al. and Avila et al. showed that there is an increased risk of prosthetic joint infection if corticosteroid injections are administered within 90 days of arthroplasty on the same joint. Little is known about the infection risk, postoperative complications, and pain outcomes if contralateral knees are injected perioperatively or intraoperatively.

This retrospective cohort study investigated patients with bilateral knee OA (n = 390) from January 2014 to December 2024 at a multilocation health system. Patients who received an intra-articular corticosteroid injection simultaneously with contrlateral total knee arthroplasty (TKA) (n = 195) were compared with controls who received no injection within 90 days of surgery (n = 195). Medical records were reviewed for comorbidities, total perioperative dexamethasone administration, total morphine milliequivalents, and postoperative complications.

Female patients (n = 246) were 63.1% of the total cohort. Average age of the population was 67.3 (standard deviation = 9.19). Mean body mass index was 33.2 (standard deviation = 6.39). Medical comorbidities did not significantly differ (P values > 0.05). Postoperative complications between groups were not statistically significant (P values > 0.05). Pain visual analog scale distributions were nearly identical between groups.

Patients who underwent TKA with steroid injection the same day of the contralateral knee did not have statistically significant different outcomes compared to patients who underwent TKA without steroid injection. Thus, contralateral steroid injections at the time of TKA may be safe in patients with bilateral knee OA.