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Maryann Gromisch RN Guide

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Hip and Knee Injections for Osteoarthritis: The Side Effects

By Joanna Karpasea-Jones
 
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If you have osteoarthritis and are considering having a hip injection, there are some side effects to consider beforehand.

Minor Side Effects

These can be pain at the injection site, post-injection cortisone "flare" (this is when the steroid makes the pain worse instead of better), facial flushing, atrophying of fat and joint infection. In black patients there may be loss of skin pigmentation at the site of the injection.

Sometimes the injection may not relieve pain and your doctor will not know if the injection will be beneficial to you until after it is done. If you are diabetic, it may cause hyperglycemia.

Moderate and Severe Side Effects

Septic arthritis (this occurs in rates of one per 3,000 to one per 5,000 injections), osteonecrosis (bone death), and an increased risk of infection after a total hip replacement operation, suppression of the pituitary and adrenal glands, decrease in bone formation, osteoporosis, joint tissue damage, mood swings, insomnia, depression and personality changes.

Death has occurred after intra-articular steroid injection, due to anaphylactic shock.

Acceleration of Joint Degeneration

Having a hip injection may accelerate the joint degeneration in the long-term. This is because inflammation is part of the immune system response and occurs when the body’s defense cells leave the blood and enter the tissue around the injured site in an attempt to heal it.

If this process is stopped, then the body’s attempt at healing itself is stopped which may result in speeding up of the osteoarthritis. However, prolonged inflammation can be harmful.

System Absorption and Immune System Depression

Intra-articular joint injections are localized to the affected joint so any immune suppressant effect should occur only in that joint. However, it is possible that system absorption may occur in rare cases, so that the effect of the steroid is throughout the body. This has led patients to be misdiagnosed with endocrine disorders they did not have. If this happens, the person will be immune-compromised. (5)

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