Corticosteroid Injections Within 2 Weeks After Knee Arthroscopy Are Associated With Increased Infection Risk.

Purpose: Our purpose was to quantify the risk of 90-day postoperative infection after arthroscopy, stratified by specific time intervals of corticosteroid injections (CSIs) postoperatively (0-2 weeks, 2-4 weeks, 4-6 weeks, and 6-8 weeks), using a large, all-payer database.
Methods: A national, all-payer database was queried. In the primary and secondary analyses, the main outcome was infection at 90 days. Infection was defined by documentation of a septic knee or surgical-site infection according to International Classification of Diseases, Ninth Revision and Tenth Revision codes, and Current Procedural Terminology codes.
Results: In the multivariable regression, the odds ratio (OR) of postoperative infection at 90 days was greater in the cohorts receiving CSIs within 0 to 2 weeks (OR, 3.31; 95% confidence interval, 1.85-5.92; P < .001) and 2 to 4 weeks (OR, 2.72; 95% confidence interval, 1.57-4.71; P = .003) than in the control group. On comparison of CSIs administered within 0 to 2 weeks and CSIs administered within 2 to 4 weeks, we observed a greater odds of postoperative infection (OR, 2.50) at 90 days after arthroscopy.
Conclusions: CSIs given within 2 weeks after knee arthroscopy increase the risk of postoperative infection the most, whereas CSIs given within 4 weeks increase the risk but to a lesser degree.
Level of Evidence: Level III, retrospective, comparative, prognosis study.
Competing Interests: Disclosures The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: C.B. performs consulting for Arthrex and Supreme Orthopedic Systems and receives payments/royalties from Arthrex. Y.K. owns stock options in Think Surgical; receives research support from Episurf; and is on the editorial board of Journal of Knee Surgery and Knee. R.E.D. receives research support from Biocomposites, CyMedica Orthopedics, DePuy Synthes, Flexion Therapeutics, Microport, Orthopedics, Orthofix, Patient-Centered Outcomes Research Institute (PCORI), Smith & Nephew, Stryker, Tissue Gene, and United Orthopedic. All other authors (J.D., H.S., O.S., S.S.B., D.H.) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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