Evidence map›Paper›PMID 34626227›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2022

Intra-articular steroid injection at the time of knee arthroscopy increases risk of post-operative infection.

Morgan Kohls, Robert Magnussen, Sean Fitzpatrick, Christopher Kaeding, David Flanigan, Robert Duerr

Abstract read
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Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Morgan KohlsDepartment of Orthopedic Surgery, Jameson Crane Sports Medicine Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Columbus, OH, 43202, USA.
Robert MagnussenDepartment of Orthopedic Surgery, Jameson Crane Sports Medicine Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Columbus, OH, 43202, USA.
Sean FitzpatrickDepartment of Orthopedic Surgery, Jameson Crane Sports Medicine Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Columbus, OH, 43202, USA.
Christopher KaedingDepartment of Orthopedic Surgery, Jameson Crane Sports Medicine Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Columbus, OH, 43202, USA.
David FlaniganDepartment of Orthopedic Surgery, Jameson Crane Sports Medicine Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Columbus, OH, 43202, USA.
Robert DuerrDepartment of Orthopedic Surgery, Jameson Crane Sports Medicine Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Columbus, OH, 43202, USA. Robert.duerr@osumc.edu.ORCID http://orcid.org/0000-0002-8816-9091

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the risk of post-operative infection after intra-articular steroid injection at the time of knee arthroscopy at a single institution high-volume sports medicine practice.

methodsThe electronic medical record at a single institution was queried for all patients who underwent knee arthroscopy from 2011 to 2019. Patients were included if they underwent more simple arthroscopic procedures: diagnostic arthroscopy, meniscectomy, loose body removal, synovectomy, or microfracture. Patients were excluded if they underwent more complex procedures, such as ligament reconstruction, meniscus repair, or any open procedures. These patients' medical records were then queried for current procedural terminology and international classification of disease codes indicating post-operative infection. Individual chart review was performed on this group of patients to determine if a true postoperative infection occurred within 6 months of the index arthroscopy. Patients were then categorized into "intra-operative steroid injection" versus "no steroid" based on each surgeon's preferred intra-operative analgesic injection cocktail.

resultsA total of 6889 patients were identified, including 2416 (35.1%) who were given intra-articular steroid at the time of knee arthroscopy. Post-operative infection occurred in 10 patients (0.15%) at a median of 18 days (range 9-42 days), 7 who received intra-operative steroid injection (0.29%) and 3 who did not (0.067%), p = 0.040. The relative risk of infection for those who received intra-operative steroid injection was 4.32 times higher than those who did not, with a number needed to harm of 448. There were no significant differences in age, body mass index, smoking status, or the prevalence of diabetes between those who got infected and those who did not.

conclusionsKnee infection following arthroscopic surgery is rare. Intra-operative steroid injection during arthroscopic knee surgery is associated with a 4.3-fold increased risk of subsequent knee infection. While the overall risk remains low, the use of intra-operative steroids is expected to result in one additional knee infection for every 448 arthroscopic procedures performed. LEVEL OF EVIDENCE: IV.

Indexed as

ArthroscopyKnee JointHumansInjections, Intra-ArticularPostoperative ComplicationsSynovectomyInfectionIntra-operative injectionKnee arthroscopySteroids

Identifiers

PMID34626227

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.