A recent cortisone shot may change the surgery date

The surgeon needs the procedure date before booking surgery

Tell both offices before another shot if knee replacement is already being discussed. Your surgeon may require a waiting period based on your health and planned operation.

Don't trust memory when the office can give you the record. Keep the date, knee side and product name where you can find them.

Brief relief doesn't mean the worn parts of the knee have improved. Keep the surgery visit when sleep, walking and basic movement remain badly limited.

Another cortisone shot may not buy enough relief

Cortisone often works sooner than other choices, but its relief can be brief. When each shot helps less, another may cost money without giving you much easier movement.

One trial gave people cortisone every twelve weeks for two years and found more cartilage loss, yet their soreness wasn't better than the soreness of people given salt-water shots for comparison. That matters when you're thinking about years of repeat care.

The trial doesn't set one safe limit for everyone. Ask which daily task the next shot may help and when you'll judge the change.

If surgery remains possible, tell the surgeon before another shot is scheduled. Fever with a hotter, more swollen knee after a procedure needs prompt medical care.

Sources

1. A meta-analysis found ipsilateral intra-articular corticosteroid injection within 3 months BEFORE joint arthroplasty was associated with increased periprosthetic joint infection risk, and the authors recommend against performing arthroplasty on a joint injected within that window - while injections given at any time overall showed no such association.

   Lai Q, et al. — Prior Intra-articular Corticosteroid Injection Within 3 Months May Increase the Risk of Deep Infection in Subsequent Joint Arthroplasty: A Meta-analysis.. Clin Orthop Relat Res, 2022. DOI: 10.1097/CORR.0000000000002055.

2. In a 3,822-patient cohort, 31.3% of those who received corticosteroid injections went on to knee arthroplasty versus 5.0% of those who did not; after matching, the hazard ratio was 1.57 (95% CI 1.37 to 1.81) and each injection raised the absolute nine-year risk of arthroplasty by 9.4%.

   Wijn SRW, et al. — Intra-articular corticosteroid injections increase the risk of requiring knee arthroplasty.. Bone Joint J, 2020. DOI: 10.1302/0301-620X.102B5.BJJ-2019-1376.R1.

3. The RUbICOn mixed-methods HTA study, commissioned specifically to address uncertainty about recurrent injections, combined a UK primary-care cohort (2005-2020) linked to hospital data with a safety analysis, patient and clinician interviews, and a three-round Delphi to set research priorities - the current formal acknowledgement that the long-term risks and benefits of repeat injections remain unresolved.

   Whitehouse MR, et al. — RecUrrent Intra-articular Corticosteroid injections in Osteoarthritis: the RUbICOn mixed-methods study.. Health Technol Assess, 2025. DOI: 10.3310/LFAJ9337.

4. The 2015 Cochrane review of 27 trials (1,767 participants) found intra-articular corticosteroid better than sham for knee OA pain (SMD -0.40, 95% CI -0.58 to -0.22; NNTB 8), but the benefit decayed with time: moderate at 1-2 weeks, small at 13 weeks, and no evidence of any effect at 26 weeks. All outcomes were graded LOW quality.

   Jüni P, et al. — Intra-articular corticosteroid for knee osteoarthritis.. Cochrane Database Syst Rev, 2015. DOI: 10.1002/14651858.CD005328.pub3.

5. In a 2-year double-blind RCT of 140 patients with symptomatic knee OA and ultrasound synovitis, 40 mg intra-articular triamcinolone every 12 weeks produced significantly greater cartilage volume loss than saline (index compartment cartilage thickness change -0.21 mm vs -0.10 mm; between-group difference -0.11 mm, 95% CI -0.20 to -0.03) with no significant difference in knee pain.

   McAlindon TE, et al. — Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial.. JAMA, 2017. DOI: 10.1001/jama.2017.5283.