hip injection, with 80mg Depo?

[jonnylingo]

Typically I inject 40mg. Never had AVN complication, knock on wood.

Got a request from Ortho to perform interarticular hip injection with 80mg of Depo. If fails, then surgery is next step.

Do it? Or go with my usual 40mg?

Any input appreciated.

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[Taus]

That's a peculiar request re asking for the specific dose of steroid...


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[RUOkie]

I've never seen any good literature on corticosteroid dose with IA corticosteroids.

But the fact remains that AVN should not be a concern of yours since the patient will go on to THA if the injection doesn't work regardless.

 

[lobelsteve]

40 to 80 is usual range.

 

[SSdoc33]

doesnt matter. if surgeon wants 80, inject 80. i always use 80

 

[freddydpt]

I'll use 80mg if that's the only injection the patient will have that month. If they are having multiple sites, I typically split the dose.

 

[padresp]

There are a few articles on this kind of thing, for different joints. 40 or 80 should be safe, and are relatively common doses.

http://www.ncbi.nlm.nih.gov/pubmed/16873380
http://www.ncbi.nlm.nih.gov/pubmed/23507791
http://www.ncbi.nlm.nih.gov/pubmed/22030233
http://www.ncbi.nlm.nih.gov/pubmed/26233499

 

[RUOkie]

There are a few articles on this kind of thing, for different joints. 40 or 80 should be safe, and are relatively common doses.

http://www.ncbi.nlm.nih.gov/pubmed/16873380
http://www.ncbi.nlm.nih.gov/pubmed/23507791
http://www.ncbi.nlm.nih.gov/pubmed/22030233
http://www.ncbi.nlm.nih.gov/pubmed/26233499

the largest n of these was 120. None showed an increase in complications, but with that small of a sample size, we would not expect to see an increase (since the complication rate is so low in all intra articular joint injections)

 

[ampaphb]

Do what you are comfortable with, not what the surgeon requests.