Side effects of cortizone injection
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Side Effects of Cortisone Injections
Cortisone injections, commonly used to reduce inflammation and pain in various joint disorders, can have several side effects. This article synthesizes findings from multiple studies to provide a comprehensive overview of these adverse effects.
Temporomandibular Joint (TMJ) Inflammation
Condylar Resorption and Other Complications
Corticosteroid injections are frequently used to treat temporomandibular joint (TMJ) inflammation. While they are effective in reducing inflammation and pain, several studies have reported significant side effects. One of the most notable complications is condylar resorption, a condition where the bone in the jaw joint deteriorates. This side effect was reported in seven out of thirteen studies reviewed, indicating a substantial risk associated with the treatment .
Need for Alternative Treatments
Given the potential for serious side effects, there is a growing consensus on the need for alternative treatments with fewer adverse effects. The reviewed studies suggest that while corticosteroids are beneficial, their complications necessitate further research into other anti-inflammatory drugs that could replace corticosteroids in treating TMJ disorders .
Rotator Cuff Tendon Health
Increased Risk of Revision Surgery
Corticosteroid injections are also used in the treatment of rotator cuff tendinosis. However, these injections have been linked to an increased risk of adverse outcomes, particularly when administered before rotator cuff repair (RCR) surgery. Studies have shown that a single corticosteroid injection can significantly increase the risk of needing revision surgery if administered up to a year before the initial surgery. The odds ratios (OR) for revision surgery range from 1.3 to 2.8, depending on the timing of the injection .
Post-Operative Infections
Another significant risk associated with corticosteroid injections in rotator cuff tendinosis is the increased likelihood of post-operative infections. The risk is particularly high if the injection is given within a month before the surgery, with an OR of 2.1. The risk remains elevated if the injection is administered within six months of the surgery or if multiple injections are given within a year .
Temporal and Dose-Dependent Risks
The adverse effects of corticosteroid injections on rotator cuff tendon health are both temporal and dose-dependent. The greatest risks are observed when injections are administered within six months of surgery or when two or more injections are given within a year. This highlights the need for careful consideration and timing when using corticosteroid injections in patients who may require surgical intervention .
Conclusion
While cortisone injections are effective in managing inflammation and pain in conditions like TMJ disorders and rotator cuff tendinosis, they come with significant side effects. These include condylar resorption in TMJ treatments and increased risks of revision surgery and post-operative infections in rotator cuff treatments. Given these risks, it is crucial to explore alternative treatments with fewer adverse effects and to carefully consider the timing and dosage of corticosteroid injections.
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