When it comes to knee pain, steroid injections can be a godsend. These powerful hormones trigger the body’s own healing mechanisms and dramatically reduce pain, giving many patients the sensation of a new lease on life.
But all that relief isn’t free: steroids can also suppress immune response, which can create problems if surgery is on the horizon. That’s the conclusion of a couple of new studies, which found that the incidence of infection among knee and hip replacement surgery patients is markedly higher if they have taken a course of steroids in the month before the procedure:
The infection rate one year after surgery for patients who did not have an injection was 2.06 percent, but for patients who had an injection it jumped to 2.8 percent — a 40 percent increase. The strongest period for increased risk was the 12 weeks before surgery, with injections given more than three months before surgery having a significantly lower infection rate of 0.87 percent.
It is one more data point in our ongoing effort to mediate pain without usurping the body’s natural healing response. If nothing else, these studies should stand as a reminder that pain management requires a sophisticated understanding of the risks and benefits involved, and that orthopedic surgery can levy its own demands on the treatment of chronic pain.