Blog: Potentially dangerous Cortisone injections need more claim form transparency

21st October 2019

Written by Senior Medical Negligence Solicitor, Patricia Hitchen

Cortisone injections are in use throughout the UK to treat osteoarthritis pain in the hip and knee. However, recent research identifies that these injections may be more dangerous than previously thought.

Osteoarthritis of the hip and knee are common and debilitating joint disorders and Physicians often inject anti-inflammatory corticosteroids into joints to treat pain and swelling.

Are injections masking a bigger problem?

Many health experts believe Hydrocortisone injections, an injection to alleviate painful or swollen joints, to be safe. Furthermore, the associated risks of haemorrhage, infection and other side effects are discussed within patient consent forms.

Research shows that the injections release the steroid slowly into the source of pain before targeting the immune system’s over activity to reduce inflammation. This consequently relieves the pain and swelling.

Despite this, patients are now asking whether these injections merely mask the problem and accelerate the degeneration of the joint?

Injection dosage and long-term problems

A recent study carried out by Boston University School of Medicine questions whether repeated cortisone injections are an appropriate solution. Also, there are new questions around the injection’s current dosage and whether repeat injections cause damage to tissue over time.

Ultimately, patients want to know if cortisone injections make an already painful problem more problematic and debilitating.

Research shows that hip and knee pain injections might be dangerous

Research leader, Dr Ali Guermazi of Boston University School of Medicine in the US, said:

We’ve been telling patients that even if these injections don’t relieve your pain, they’re not going to hurt you. However, we suspect that this is not necessarily the case.

We are now seeing that these injections can be very harmful to the joints with serious complications.

Throughout 2018 doctors in the US reviewed results from 459 patients who received a steroid injection into their hip or knee joint. They found 8% of patients had problems after an injection, including more pain and the breakdown of cartilage in the joint.

In short, the review concluded that steroid injections are not as safe as first thought and that they might worsen joint symptoms.

Is there enough risk awareness on patient consent forms?

Is the current consent process transparent?

The University’s research asks further questions on the suitability of these injections and whether the current consent process is transparent enough.

For example, if your hip joint is severely arthritic, a cortisone injection may bring temporary relief. However, because the hip is a weight-bearing joint, a single injection will only relieve pain for about six months.

For a mildly arthritic hip, physical therapy, analgesics and NSAIDs can provide relief. Therefore, younger patients, and those who are in the earlier stages of the disease, need to be fully informed about the potential consequences before it is provided. 

Ultimately, is there enough risk awareness about joint collapse or subchondral fractures that result in a total hip or knee replacement?

Back on home soil, the NHS provides the injections for those suffering moderate to severe osteoarthritis and inflammatory conditions such as rheumatoid arthritis.

The injections are also used to alleviate symptoms in sports medicine.

Although current procedures are seen as safe, the question stands, do patient consent forms accurately portray an 8% chance of future debilitation?

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