Hip Joint Injection 

Hip osteoarthritis or labral tear

The hip joint is one of our weight-bearing joints and is the articulation between your femur and the acetabulum from the pelvis. This joint can become arthritic because we walk and bear weight on it throughout our life. Joint space will narrow, the cartilage will wear down, and you may even develop a labral tear within the joint. As a result, you may have pain with walking which is often in the groin and front of the thigh. In rare cases, it may refer to the knee joint. 

Procedural Treatment

If physical therapy and a course of NSAIDs have not helped, your doctor may recommend diagnostically or therapeutically injecting your hip joint. If an anesthetic is injected into the joint, it will serve as a diagnostic step. If the combination of anesthetic and steroid is injected, it will be therapeutic. Alternatives to steroids, patients may choose to treat the osteoarthritis with regenerative options including PRP and bone marrow aspirate which may contain stem cells.

Risks Associated with Procedure

​The hip injection is a routine treatment but it can be associated with medical and surgical complications. Following is the list of potential complications associated with x-ray guided or ultrasound-guided joint injection

  • Allergic reaction to meds

  • Infection

  • Bleeding

  • Femoral Nerve Injury

  • Temporary increase in pain

  • Osteoporotic bone fracture

  • Avascular necrosis (if steroid used)

  • High blood sugar levels(if steroid used)

  • Transient vaginal spotting

  • Transient facial flushing (if steroid used)

  • A transient decrease in immunity and development of other infection including UTI

  • Stomach ulcers

  • Progressive arthritis of the hips

  • Cataracts (if steroid used)

  • Increased appetite

  • Agitation and irritability

  • Negative effect on bone density and fractures (if steroid used)

  • Lack of benefit

  • Radiation burn from x-ray

A sample of medications that have to be held includes:

  1. Aggrenox® (dipyridamole)

  2. Coumadin® (warfarin)

  3. Effient® (prasugrel)

  4. Fragmin® (dalteparin)

  5. Heparin

  6. Eliquis ® (apixaban).

  7. Lovenox® (enoxaparin)

  8. Plavix® (clopidogrel),

  9. Pradaxa® (dabigatran)

  10. Ticlid® (ticlopidine)

 

Prepare for your Procedure:

1.  We will ask you to hold anticoagulants or blood thinners to prevent complications.  Do not hold medication on her own.
2.  Call us if you have any symptoms of cold, infection, or your antibiotic or you are ill or hospitalized.  Also, let us know if your symptom has resolved and no longer requires treatment.

3. Wear dark undergarments and dark clothing.  The cleaning solutions may stain your clothes.

During the procedure:

You will lay on your back.  The area of the right groin proximal thigh will be cleaned up with a disinfectant solution.  A sterile drape will be placed.  Your skin would be anesthetized.  You may feel the pressure of the needle as it is inserted and advanced into the hip joint.  The doctor will inject some contrast to identify the location of the needle tip.  Once the needle is within your hip joint, the injection will be completed.  The needle will be removed, your skin will be cleaned off and Band-Aid will be applied before you return to the recovery area.

 

After Procedure

  • You will be observed for 15-30 minutes.

  • A nurse will check your vitals and review the discharge instructions with you and will answer any questions you may have. A responsible adult must be present to drive you home after discharge.

  • You will leave with a pain log and a copy of the discharge instruction which contains Emergency contact numbers. Please do not discard your discharge instructions.

Discharge Instructions

  • Take band-aid off the day after the procedure.

  • Ice area the night of the procedure. (if sore)

  • May take Tylenol or Motrin if you have some soreness.

Call your doctor if you develop these symptoms. YOU MAY BE DIRECTED TO ER:

  • Sudden weakness or shortness of breath

  • Acute worsening  of groin pain and limping beyond what you have been experiencing before

  • Fever over 101°F within 5 days after the procedure

  • Persistent redness, increased localized pain, or discharge from the site of injection.

  • Possible allergic reaction within 5 days of the procedure

  • Significantly increased pain not responding to ice, NSAIDS and pain meds or associated with fever