• Nayeem Baksh, Jennifer I Etcheson, Scott Liu, Chibuokem P Ikwuazom, Zhongming Chen, Jeremy A Dubin, Daniel Hameed, and Qais Naziri.
• Department of Orthopaedic Surgery and Rehabilitation Medicine, Downstate Medical Center, State University of New York (SUNY), 450 Clarkson Avenue, MSC 30, Brooklyn, NY, 11203, USA.
• Arch Orthop Trauma Surg. 2023 Sep 1; 143 (9): 560956145609-5614.

IntroductionCorticosteroid injections (CSI) may increase the risk of peri-prosthetic infections (PJI) following total shoulder arthroplasty (TSA). Our study specifically assessed the risk of PJI in patients who received CSI: (1) less than 4 weeks prior to TSA; (2) 4-8 weeks prior to TSA; and (3) 8-12 weeks prior to TSA.Materials And MethodsA national all-payer database was queried to identify patients who underwent TSA with a shoulder osteoarthritis diagnosis from October 1, 2015 to October 31, 2020 (n = 25,422). There were four cohorts: CSI within 4 weeks of TSA (n = 214), CSI 4-8 weeks prior to TSA (n = 473), CSI 8-12 weeks prior to TSA (n = 604), and a control cohort that did not receive CSI (n = 15,486). Bivariate chi-square analyses of outcomes were performed in addition to multivariate regression.ResultsA significant increase in PJI risk at 1 year (Odds Ratio [OR] = 2.29, 95% Confidence Interval [CI] = 1.19-3.99, p = 0.007) and 2 years (OR = 2.03, CI = 1.09-3.46, p = 0.016) in patients who received CSI within 1 month of TSA was noted. PJI risk was not significantly increased at any time point for patients who received a CSI greater than 4 weeks prior to TSA (all p ≥ 0.396).ConclusionPJI risk is increased at both 1 and 2 years post-operatively in patients who received a CSI within 4 weeks of TSA. Therefore, TSA should be deferred at least 4 weeks after a patient receives a CSI to mitigate PJI risk.Level Of EvidenceLevel III.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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