As I frequently discuss or write, the old model for arthritis and tendinitis treatment is inadequate and needs to change.  There is evidence that steroid injections, a traditional mainstay of orthopedic treatment, can worsen future surgical outcomes as well.

A recent study of people with hip arthritis who received a hip replacement found that rates of infection and hip revision surgery are increased dramatically if a steroid injection was given into that hip within 1 year of their surgery.  This suggests that the lingering side effects within a joint last longer than most physicians have previously thought. 

It has also been shown that for individuals with carpal tunnel syndrome who have surgical decompression prior steroid injection worsens outcome.  The greater the number of steroid injections the more likely patients remain symptomatic after surgery.

An argument for cellular biologic treatments in place of surgery can certainly be made.  There is growing evidence in favor of treatments such as PRP and autologous mesenchymal stem cells for orthopedic conditions such as osteoarthritis, tendinitis, ligament injuries, and certain nerve compression conditions.  With more recent evidence that steroid injections can worsen future surgical outcomes for that same joint, tendon, or nerve, it does not make sense to use steroids for these conditions.  If you are considering effective and safe non-surgical treatments, favor the newer cellular treatments that work on the source of your problem.   


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