Aims. Using a systematic review, we investigated whether there is an
increased risk of post-operative infection in patients who have
received an intra-articular corticosteroid injection to the hip
for osteoarthritis prior to total hip arthroplasty (THA). Methods. Studies dealing with an intra-articular corticosteroid injection
to the hip and infection following subsequent THA were identified
from databases for the period between 1990 to 2013. Retrieved articles
were independently assessed for their methodological quality. Results. A total of nine studies met the inclusion criteria. Two recommended
against a steroid injection prior to THA and seven found no risk
with an injection. No prospective controlled trials were identified.
Most studies were retrospective. Lack of information about the methodology
was a consistent flaw. Conclusions. The literature in this area is scarce and the evidence is weak.
Most studies were retrospective, and confounding factors were poorly
defined or not addressed. There is thus currently insufficient evidence
to conclude that an intra-articular corticosteroid injection administered
prior to THA increases the rate of infection. High quality, multicentre randomised
trials are needed to address this issue. Cite this article: Bone Joint J 2016;98-B:1027–35